Deep vein thrombosis laboratory tests: Difference between revisions
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'''Editors-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] '''Associate Editor-In-Chief''': [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org] | '''Editors-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] '''Associate Editor-In-Chief''': [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]][mailto:urastogi@perfuse.org]; [[User:Kashish Goel|Kashish Goel, M.D.]] | ||
{{Deep vein thrombosis}} | {{Deep vein thrombosis}} | ||
==Overview== | ==Overview== | ||
The lifetime incidence of [[DVT]] ranges from 2-5% in general population. It accounts for a large number of ER visits and puts the patient at-risk for life-threatening [[pulmonary embolism]]. The use of D-dimer after assessment of pre-test probability has been widely validated now and has led to a significant reduction in unnecessary procedures in the ER and hospital settings. This chapter will review the role of D-dimer in diagnosis of [[DVT]]. For detailed discussion on D-dimer, please visit '''{{main|d-dimer}}'''. | |||
==D-dimer== | ==D-dimer== | ||
Revision as of 14:32, 18 May 2012
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS[1]; Kashish Goel, M.D.
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Overview
The lifetime incidence of DVT ranges from 2-5% in general population. It accounts for a large number of ER visits and puts the patient at-risk for life-threatening pulmonary embolism. The use of D-dimer after assessment of pre-test probability has been widely validated now and has led to a significant reduction in unnecessary procedures in the ER and hospital settings. This chapter will review the role of D-dimer in diagnosis of DVT. For detailed discussion on D-dimer, please visit
.
D-dimer
In a low-probability situation, current practice is to commence investigations by testing for D-dimer levels. This cross-linked fibrin degradation product is an indication that thrombosis is occurring, and that the blood clot is being dissolved by plasmin. A low D-dimer level should prompt other possible diagnoses (such as a ruptured Baker's cyst, if the patient is at sufficiently low clinical probability of DVT.[1][2]
It should be noted that latex D-dimer assays are insensitive and have no role in screening for deep vein thrombosis.
Other blood tests
Other blood tests usually performed at this point are:
- complete blood count
- Primary coagulation studies: PT, APTT, Fibrinogen
- liver enzymes
- renal function and electrolytes
- prostate specific antigen measurement in men over the age of 50.
References
- ↑ Wells PS, Anderson DR, Rodger M; et al. (2003). "Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis". N. Engl. J. Med. 349 (13): 1227–35. doi:10.1056/NEJMoa023153. PMID 14507948.
- ↑ Bates SM, Kearon C, Crowther M; et al. (2003). "A diagnostic strategy involving a quantitative latex D-dimer assay reliably excludes deep venous thrombosis". Ann. Intern. Med. 138 (10): 787–94. PMID 12755550.