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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com


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viernes, 4 de enero de 2013


Shifting Up Cutoff Value of D-Dimer in the Evaluation of Pulmonary Embolism: A Viable Option? Possible Risks and Benefits
Raviv B and Israelit S. Emergency Medicine International 2012 (2012), Article ID 517375, 6 pagesdoi:10.1155/2012/517375
"Objectives. To evaluate the viability of the possibility to use a higher D-dimer value than the one used today in the clinical algorithms evaluating patients suspected to have pulmonary embolism. Methods. A retrospective analysis of 300 serial patients for whom D-dimer values were taken during a 10 month period in the emergency room of a tertiary medical center. Results. Our analysis showed that it may be safe and cost effective to use a D-dimer value of 900ng/ml rather than the value of 500ng/ml accepted today, with sensitivity of 94.4%. In younger patients [under 40 years] the sensitivity reached was even higher- 100%. Conclusions. Raising cutoff values of D-dimer in screening for pulmonary embolism seems a viable option. There may be a place for tailoring cutoff values according individual patient characteristics, such as according age groups. More studies of the subject are warranted."