Knappast djup ventrombos vid normal D-dimer. Träffsäker metod minskar behovet av benflebografi, visar retrospektiv studie
Engelsk titel: Hardly deep venous thrombosis with normal D-dimer. A sensitive method reduces the need for leg phlebographpy according to a retrospective study
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Författare:
Noel R
;
Aspelin P
;
Brismar TB
Email: rozh.noel@karolinska.se
Språk: Swe
Antal referenser: 13
Dokumenttyp:
Artikel
UI-nummer: 10011295
Sammanfattning
Background: Deep vein thrombosis (DVT) is a serious condition which if untreated can lead to pulmonary embolism. Clinical assessment has been shown to be insufficient, and additional diagnostic tests are therefore necessary. Available tests include measurement of D-dimer in blood samples, ultrasound and phlebography. This retrospective study evaluates if a negative D-dimer excludes DVT in patients with clinically suspected DVT. Methods: Retrospective study of acute phlebographies of lower extremity comparison to D-dimer levels in blood. Results: D-dimer was collected and a phlebography of lower extremity was made at our X-ray department in 540 outpatients during year 2007. Of these 81 had a DVT. DVT was diagnosed in 33 of 287 women (11 %) who underwent phlebograhy and in 48 of 253 men (19 %). D-dimer sensitivity was 98%, specificity was 33%, and the negative predictive value was 99%. Of 157 patients with normal D-dimer only 2 patients (1%) had radiological signs of DVT on phlebography. We conclude that a negative D-dimer has a very high negative predictive value in out-patients with clinically suspected DVT.