EVALUATION OF A RAPID BLOOD-TEST FOR THE EXCLUSION OF VENOUS THROMBOEMBOLISM IN SYMPTOMATIC OUTPATIENTS

OBJECTIVES: The SimpliRED whole blood D-dimer assay for exclusion of d eep venous thrombosis in symptomatic outpatient appears to be a simple and rapid method; we wanted to confirm its reliability. METHODS: Fift y consecutive outpatients (mean age 57, range 20 to 89) referred to ou r department between September and December 1996, for clinically suspe cted deep venous thrombosis (DVT) were included. Hospitalized patients were excluded as well as patients under anticoagulant and pregnant wo men. DVT was diagnosed with our usual strategy of compression ultrason ography at the levels of the common femoral, the superficial femoral a nd the popliteal veins including the exploration of sural and saphenou s veins. The D-dimer assay was performed, according to the manufacture r recommandation, blindly by a physician unaware of the results of ult rasonography within one hour. RESULTS: Eight of nineteen patients with DVT had a normal D-dimer test result Four had a sural DVT, but four h ad a proximal DVT. Furthermore four patients with normal D-dimers had superficial venous thrombosis, CONCLUSION: Our series does not confirm the high sensitivity and negative predictive value reported previousl y. To date it is premature to propose this assay as a first line test in the therapeutic management of patients with suspected DVT.