Can Previous D-Dimer Levels Predict Future Elevations in Emergency Department Patients?

Authors : Yeşim Eyler, Murat Yeşilaras, Turgay Yılmaz Kılıç, Inanc Karakoyun, Deniz İlhan Topcu
Pages : 54-58
Doi:10.54996/anatolianjem.1655313
View : 61 | Download : 38
Publication Date : 2025-06-26
Article Type : Research Paper
Abstract :Aim: Excluding or confirming pulmonary embolism in the emergency department requires an effective and rapid strategy. The D-dimer cut-off value adjusted for age and clinical probability has been determined in prospective studies, allowing safe exclusion in more patients. However, no recommendations exist for predicting new test results based on the previous D-dimer values. This study aimed to investigate the risk of high d-dimer test results in patients undergoing D-dimer testing in the emergency department, based on patient characteristics and previous test results. Material and Methods: This retrospective study used data from patients who underwent D-dimer testing between January 1, 2009, and December 31, 2019, in a tertiary hospital ED. Patients with an interval between two D-dimer results of 30 days to 1095 days were included in the study. The D-dimer value to be estimated was expressed as the index D-dimer value, and the D-dimer value used to estimate this value was expressed as the previous D-dimer value. The upper limit value of D-dimer was determined according to the patient\\\'s age at the test date. Binary logistic regression analysis was used in the analysis of factors associated with high D-dimer values. All analyses were performed at a 95% confidence interval. p-values below 0.05 were considered significant. Results: The median age of the 358 patients included in the study was 61 years, and 60.6% were female. If the previous D-dimer value was above the normal value, the odds of an elevated index value increased 4.170-fold. In addition, If the previous D-dimer value exceeded 1,000 µg/L FEU, the odds increased 4.704-fold. Conclusion: In patients with previously elevated D-dimer values within the past three years, the new D-dimer value is likely to be high. In such cases, performing advanced diagnostic tests instead of waiting for the test results may save time.
Keywords : D-dimer, acil servis, acil tıp, pulmoner emboli, venöz tromboembolizm

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