EVALUATION OF THE ROLE OF D- DIMER TEST IN THE PREDICTION AND EXCLUSION OF VENOUS THROMBOEMBOLISM IN COMBINATION WITH PRETEST PROBABILITY SCORE AT A TERTIARY CARE CENTRE.

Abstract

Background: Clinical suspicion of venous thromboembolism requires objective testing to predict and exclude the diagnosis. Plasma D-dimer is sensitive marker for thrombosis but lack specicity. The combined use of pretest probability score and D-dimer can be used for exclusion of VTE and safely avoid costly imaging tests. Material and Methods: In this prospective observational study, we used Wells PTP score and D-dimer test to evaluate 50 patients who presented with sign and symptoms of VTE. Radiological imaging studies were taken as conrmatory test. Result: The sensitivity, specicity and NPV of D-dimer test were 100%, 83.7% and 100% respectively. The sensitivity, specicity and NPV of Ddimer test in combination with low PTP score were 100%, 72.1% and 100% respectively. The agreement between radiologically conrmed cases and D-dimer test was signicant. Conclusion: D-dimer test can be safely used in low or moderate PTP score patients to exclude VTE and costly invasive radiological imaging studies can be obviated in a signicant proportion of patients.