Rapid ELISA D-dimer testing in the exclusion of venous thromboembolism in hospitalized patients

The clinical diagnosis of deep-vein thrombosis (DVT) and pulmonary embolism (PE) is known to be unreliable. Until now, Ilo biological marker has been found to confirm thrombosis, but help can be gained from a biological marke r ruling out the diagnosis of DVT or PE, i.e., the sensitive measurement of D-dimer (DD) species. This article summarizes our experience in introducin g a rapid D-dimer test (ELISA VIDAS D-dimeres test, bioMerieux) in a collab orative strategy for thrombosis diagnosis during 9 consecutive months invol ving 1,131 measurements. The efficacy of the DD test was very different acc ording the type of patient, and departments where the DD test provides a re al diagnostic benefit were identified. High clinical probability for thromb osis was encountered in 32 patients and radiology was carried out, although D-dimer was negative: none of these patients was found to have a thrombosi s after radiologic examination. However, extensive progress must be made in test prescription to reduce the excessive rate of positive D-dimer tests ( 78%) and positive measurements that are not followed up by radiology (42%).