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Ned Tijdschr Geneeskd · Jan 2010
Review[Exclusion of deep-vein thrombosis and pulmonary embolism using clinical decision rules and D-dimer tests].
- Inge C M Mos, Melanie Tan, Frederikus A Klok, Pieter W Kamphuisen, and Menno V Huisman.
- Leids Universitair Medisch Centrum, afd. Algemene Interne Geneeskunde-Endocrinologie, Leiden, the Netherlands. i.c.m.mos@lumc.nl
- Ned Tijdschr Geneeskd. 2010 Jan 1; 154: A2054.
AbstractClinical diagnosis of a venous thromboembolism (VTE) is often difficult because the symptoms of this disorder are diverse and unspecified. The combination of a low probability clinical decision rule and an unremarkable D-dimer test is a safe way to exclude the presence of a VTE. Clinical decision rules for the diagnosis of a deep-vein thrombosis are available for primary and secondary care and clinical decision rules for the diagnosis of a pulmonary embolism is available for secondary care. Various D-dimer tests are available that differ with regard to sensitivity, specificity and duration of the measurement. During pregnancy and puerperium using a clinical decision rule and a D-dimer test is inadequate: additional radiologic investigation is always indicated in this situation. The diagnostic value of the D-dimer test during suspected recurrence of a VTE is yet to be determined.
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