dc.date.accessioned | 2021-04-23T20:08:43Z | |
dc.date.available | 2021-04-23T20:08:43Z | |
dc.date.created | 2020-12-03T13:06:36Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Frønæs, Synne Grønvold Jørgensen, Camilla Tøvik Dahm, Anders Erik A Wik, Hilde Skuterud Gleditsch, Jostein Raouf, Nezar Holst, René Klok, Frederikus A. Ghanima, Waleed Khalid . Safety of a strategy combining D-dimer testing and whole-leg ultrasonography to rule out deep vein thrombosis. Blood Advances. 2020, 4(20), 5002-5010 | |
dc.identifier.uri | http://hdl.handle.net/10852/85523 | |
dc.description.abstract | Abstract
Guidelines for the diagnostic workup of deep vein thrombosis (DVT) recommend assessing the clinical pretest probability before proceeding to D-dimer testing and/or compression ultrasonography (CUS) if the patient has high pretest probability or positive D-dimer. Referring only patients with positive D-dimer for whole-leg CUS irrespective of pretest probability may simplify the workup of DVT. In this prospective management outcome study, we assessed the safety of such a strategy. We included consecutive outpatients referred to the Emergency Department at Østfold Hospital, Norway, with suspected DVT between February 2015 and November 2018. STA-Liatest D-Di Plus D-dimer was analyzed for all patients, and only patients with levels ≥0.5 µg/mL were referred for CUS. All patients with negative D-dimer or negative CUS were followed for 3 months to assess the venous thromboembolic rate. One thousand three hundred ninety-seven patients were included. Median age was 64 years (interquartile range, 52-73 years), and 770 patients (55%) were female. D-dimer was negative in 415 patients (29.7%) and positive in 982 patients (70.3%). DVT was diagnosed in 277 patients (19.8%). Six patients in whom DVT was ruled out at baseline were diagnosed with DVT within 3 months of follow-up for a thromboembolic rate of 0.5% (95% confidence interval, 0.2-1.2). A simple diagnostic approach with initial stand-alone D-dimer followed by a single whole-leg CUS in patients with positive D-dimer safely ruled out DVT. We consider this strategy to be a valuable alternative to the conventional workup of DVT in outpatients. This trial was registered at www.clinicaltrials.gov as #NCT02486445. | |
dc.language | EN | |
dc.publisher | American Society of Hematology | |
dc.title | Safety of a strategy combining D-dimer testing and whole-leg ultrasonography to rule out deep vein thrombosis | |
dc.type | Journal article | |
dc.creator.author | Frønæs, Synne Grønvold | |
dc.creator.author | Jørgensen, Camilla Tøvik | |
dc.creator.author | Dahm, Anders Erik A | |
dc.creator.author | Wik, Hilde Skuterud | |
dc.creator.author | Gleditsch, Jostein | |
dc.creator.author | Raouf, Nezar | |
dc.creator.author | Holst, René | |
dc.creator.author | Klok, Frederikus A. | |
dc.creator.author | Ghanima, Waleed Khalid | |
cristin.unitcode | 185,53,49,11 | |
cristin.unitname | Avdeling for blodsykdommer | |
cristin.ispublished | true | |
cristin.fulltext | postprint | |
cristin.qualitycode | 1 | |
dc.identifier.cristin | 1855805 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Blood Advances&rft.volume=4&rft.spage=5002&rft.date=2020 | |
dc.identifier.jtitle | Blood Advances | |
dc.identifier.volume | 4 | |
dc.identifier.issue | 20 | |
dc.identifier.startpage | 5002 | |
dc.identifier.endpage | 5010 | |
dc.identifier.doi | https://doi.org/10.1182/BLOODADVANCES.2020002173 | |
dc.identifier.urn | URN:NBN:no-88199 | |
dc.type.document | Tidsskriftartikkel | |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 2473-9529 | |
dc.identifier.fulltext | Fulltext https://www.duo.uio.no/bitstream/handle/10852/85523/5/advancesadv2020002173.pdf | |
dc.type.version | PublishedVersion | |