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D-dimer (or D dimer) is a dimer that is a fibrin degradation product (FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two D fragments of the fibrin protein joined by a cross-link , hence forming a protein dimer .
60–79 years 1 80+ years 2 ... Authors suggest that the likelihood of patients having a PE with a simplified Geneva score less than 2 and a normal D-Dimer is 3 ...
The purpose of the rule is to select the best method of investigation (e.g. D-dimer testing, CT angiography) for ruling in or ruling out the diagnosis of PE, and to improve the interpretation and accuracy of subsequent testing, based on a Bayesian framework for the probability of the diagnosis.
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D-dimer is highly sensitive but not specific (specificity around 50%). In other words, a positive D-dimer is not synonymous with PE, but a negative D-dimer is, with a good degree of certainty, an indication of absence of a PE. [52] A low pretest probability is also valuable in ruling out PE. [53]
A D-dimer test can also be used to assist with excluding the diagnosis or to signal a need for further testing. [5] Diagnosis is most commonly confirmed by ultrasound of the suspected veins. [5] VTE becomes much more common with age. The condition is rare in children, but occurs in almost 1% of those ≥ age 85 annually. [3]
Principles of D-dimer testing. Fibrin degradation products (FDPs), also known as fibrin split products, are components of the blood produced by clot degeneration. [1] Clotting, also called coagulation, at the wound site produces a mass of fibrin threads called a net that remains in place until the cut is healed. As a cut heals, the clotting ...
10–39 years: 54 [23] 110 [23] mg/dL < 100 mg/dL [63] or 1.1 mmol/L [63] 0.61 [64] 1.2 [64] mmol/L ... D-dimer. n/a: 500 [171] ng/mL: Higher in pregnant women ...
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