Clinical utility of D-dimer in patients with suspected pulmonary embolism and nondiagnostic lung scans or negative CT findings

Chest. 2004 Mar;125(3):851-5. doi: 10.1378/chest.125.3.851.


Background: The diagnosis of pulmonary embolism is difficult because the clinical diagnosis is nonspecific and all of the objective tests have limitations. The assay for plasma d-dimer may be useful as an exclusion test if results are negative. We conducted a prospective cohort study that evaluated the clinical utility (usefulness) of an automated quantitative d-dimer test in the diagnosis of patients with suspected pulmonary embolism.

Methods: Consecutive eligible patients who had clinically suspected PE with nondiagnostic lung scans or negative helical CT scan of the chest results underwent d-dimer testing.

Results: The d-dimer results were negative in 11 of 103 inpatients (10.6%, 95% confidence interval [CI], 5.5 to 18.3%) and 7 of 22 outpatients (31.8%, 95% CI, 13.9 to 54.9%; p = 0.02).

Conclusions: Measurement of plasma d-dimer is of limited clinical utility for inpatients with clinically suspected pulmonary embolism and nondiagnostic lung scans or negative helical CT results at a US academic health center.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cohort Studies
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Humans
  • Lung / diagnostic imaging*
  • Male
  • Middle Aged
  • Prospective Studies
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / diagnosis*
  • Radionuclide Imaging
  • Sensitivity and Specificity
  • Tomography, Spiral Computed
  • Venous Thrombosis / diagnosis
  • Ventilation-Perfusion Ratio


  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D