Podcast 997: D-Dimer
About this episode
This episode discusses the role of D-dimer in evaluating clot formation and its use in assessing pulmonary embolism and aortic dissection risk.
Contributor: Travis Barlock, MD Educational Pearls: D-dimer: fibrin degradation product used to evaluate for clot formation and breakdown Threshold: Elevated D-dimer indicates recent or ongoing intravascular coagulation and fibrinolysis YEARS score: algorithm to assess PE risk using three clinical criteria Criteria: signs of DVT, hemoptysis, and PE as the most likely diagnosis YEARS score of 0 with D-dimer YEARS score of ≥1 with D-dimer A study found that YEARS score accurately predicted the presence or absence of PE in 80% of enrolled patients with 90% sensitivity and 65% specificity D-dimer may also help exclude aortic dissection: Aortic Dissection Detection Risk Score (ADD-RS) When ADD-RS = 0 or 1 and D-dimer When ADD-RS >1, patients are considered high probability for aortic dissection and CT should be performed References Fayiad, H., Moussa, H., Nosair, Y. et al. Predictive accuracy of years score in diagnosis of pulmonary embolism. Egypt J Bronchol 18, 18 (2024). https://doi.org/10.1186/s43168-024-00269-y Weitz JI, Fredenburgh JC, Eikelboom JW. A Test in Context: D-Dimer. J Am Coll Cardiol. 2017 Nov 7;70(19):2411-2420. doi: 10.1016/j.jacc.2017.09.024. PMID: 29096812. Yichao…
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