Cut-Off Value and Factors Associated with a False Positive D-Dimer Result for Venous Thromboembolism in Koreans

Hong, Man Yong; Lee, Changkun; Yoo, Sang-Yong; Shin, Dae-Hee; Cheong, Sang-Sig; Kwon, Ji Hye; Jang, Woo Sung; Yoo, Seung Jin; Oh, Kwang Hoon

doi:10.3904/kjm.2013.84.3.372

Cited by 2 publications

(2 citation statements)

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“…Therefore, it provides a useful tool for screening for VTE. Regarding VTE diagnosis, D-dimer assays are known to show high sensitivity (93%-95%) but relatively low specificity (40%-60%) [ 3 4 5 ]. Plasma levels of D-dimer are increased in the presence of thrombotic diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Plasma levels of D-dimer are increased in the presence of thrombotic diseases. Unfortunately, D-dimer levels are also increased in other conditions, such as senescence, recent surgery, stroke, trauma, infection, malignancy, acute coronary disease, heart failure, chronic renal disease, liver disease, elevated rheumatoid factors, and pregnancy [ 3 6 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Value of Elevated D-Dimer Level in Venous Thromboembolism in Patients With Acute or Subacute Brain Lesions

Kim

Jang

et al. 2015

Ann Rehabil Med

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ObjectiveTo define the risk factors that influence the occurrence of venous thromboembolism (VTE) in patients with acute or subacute brain lesions and to determine the usefulness of D-dimer levels for VTE screening of these patients.MethodsMedical data from January 2012 to December 2013 were retrospectively reviewed. Mean D-dimer levels in those with VTE versus those without VTE were compared. Factors associated with VTE were analyzed and the odds ratios (ORs) were calculated. The D-dimer cutoff value for patients with hemiplegia was defined using a receiver operating characteristic (ROC) curve.ResultsOf 117 patients with acute or subacute brain lesions, 65 patients with elevated D-dimer levels (mean, 5.1±5.8 mg/L; positive result >0.55 mg/L) were identified. Logistic regression analysis showed that the risk of VTE was 3.9 times higher in those with urinary tract infections (UTIs) (p=0.0255). The risk of VTE was 4.5 times higher in those who had recently undergone surgery (p=0.0151). Analysis of the ROC showed 3.95 mg/L to be the appropriate D-dimer cutoff value for screening for VTE (area under the curve [AUC], 0.63; 95% confidence interval [CI], 0.5-0.8) in patients with acute or subacute brain lesions. This differs greatly from the conventional D-dimer cutoff value of 0.55 mg/L. D-dimer levels less than 3.95 mg/L in the absence of surgery showed a negative predictive value of 95.8% (95% CI, 78.8-99.8).ConclusionElevated D-dimer levels alone have some value in VTE diagnosis. However, the concomitant presence of UTI or a history of recent surgery significantly increased the risk of VTE in patients with acute or subacute brain lesions. Therefore, a different D-dimer cutoff value should be applied in these cases.

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Section: Introductionmentioning

confidence: 99%