D-dimers in the emergency department evaluation of aortic dissection

Acad Emerg Med. 2004 Apr;11(4):397-400. doi: 10.1197/j.aem.2003.10.030.

Abstract

Aortic dissection (AD) is the most common acute aortic condition requiring urgent surgery. AD, if not diagnosed in the emergency department (ED), is frequently fatal. AD is a difficult antemortem diagnosis.

Objectives: To determine if acute AD is associated with an elevation of fibrin degradation products, D-dimers.

Methods: This was a retrospective chart review of patients diagnosed as having AD in the ED in whom a D-dimer determination was obtained in the ED, prior to any therapeutic intervention. The study was conducted in an urban Level I trauma center between October 1996 and September 2000. Exclusion criteria were referred patients with known diagnosis of AD. The D-dimer assay used was the semiquantitative latex agglutination assay, with a normal range up to 0.5 micro g/mL.

Results: One hundred fifty-six patients were diagnosed as having AD in the ED. Seven patients had a D-dimer assay during their workup. All seven had a positive test.

Conclusions: All seven patients with an AD who had D-dimer assays performed in the ED had positive results by latex agglutination.

MeSH terms

  • Aged
  • Aneurysm, Dissecting / blood*
  • Aneurysm, Dissecting / diagnosis*
  • Aortic Aneurysm / blood*
  • Aortic Aneurysm / diagnosis*
  • Biomarkers / blood
  • Emergency Medical Services / methods*
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Humans
  • Latex Fixation Tests
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D