DOSAGE OF THE D-DIMERS IN THE DIAGNOSIS O F DEEP-VEIN THROMBOSIS AND OR PULMONARY-EMBOLISM - REVIEW BASED ON 80 CONSECUTIVE PATIENTS SEEN AT AN EMERGENCY UNIT/

The sensitivity and specificity of an ELISA method (Fibrinostika Fbdp Organon Teknika) for assay of D-dimers in the diagnosis of deep vein t hrombosis and/or pulmonary embolism was studied in 80 consecutive pati ents seen at an emergency unit. Fifty-six of the patients presented cl inical signs of deep vein thrombosis. Diagnosis was confirmed in 26 of the 56 patients with a D-dimer level above 370 ng/ml (sensitivity 92. 3 %) and 370 ng/ml for 13 of 30 patients with a negative venous ultras ound Doppler examination (specificity 43.3 %). The positive predictive value was 58.5 % and the negative predictive value was 87 %. There wa s a significant difference in the level of D-dimers between distal and proximal deep vein thrombosis. In 40 cases with suspected pulmonary e mbolis, either alone or with suspected deep vein thrombosis, diagnosis was made in only 4 of 9 with a highly or intermediately probable vent ilation/perfusion scan. D-dimer level was always above 3,000 ng/ml. Co upling the ELISA dimer rest with noninvasive explorations improves neg ative predictive value but can also avoid invasive explorations (venog raphy, pulmonary angiography) in certain patients. A D-dimer test as s ensitive as the ELISA test and as rapid as the latex test remains to b e described (J Mal Vasc 1996;21: pages 22-30).