Can D-dimer become a new diagnostic parameter for acute appendicitis?

Am J Emerg Med. 2009 Sep;27(7):765-9. doi: 10.1016/j.ajem.2008.06.001.


Introduction: In this study, we investigated D-dimer serum level as a diagnostic parameter for acute appendicitis.

Materials and methods: Forty-nine patients were enrolled in the study. Patients were classified according to age; sex; duration between the beginning of pain and referral to a hospital or clinic; Alvarado scores; and in physical examination, presence of muscular defense, the number of leukocytes, preoperative ultrasonography, and D-dimer levels of histopathologic study groups were analyzed.

Results: Of the patients enrolled in the study, 26.5% were females and 73.5% males. The average age was 21 years (range, 16-38 years) and 81.7% acute appendicitis (AA). According the duration of pain, 63.2% of the patients were referred to the hospital within the first 24 hours, 26.5% of the patients were referred to the hospital within 24 to 48 hours, and 10.3% were referred to the hospital within a period of more than 48 hours. No statistically significant difference was determined regarding D-dimer levels between the histopathologic study groups (P > .05). Alvarado scores lower than 7 were found in 36.7% and 7 or higher in 63.3% of the patients. There was no statistically significant difference related with D-dimer levels between histopathologic study groups (P > .05). The ratio of cases with a number of leukocytes below the upper limit were determined respectively as 32.7% and 67.3%, and no statistically significant difference was found regarding d-dimer levels between histopathologic study groups (P > .05).

Conclusion: Increased D-dimer levels should not be considered as a diagnostic parameter in diagnosis of acute appendicitis.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Appendicitis / diagnosis*
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Humans
  • Male
  • Retrospective Studies
  • Sensitivity and Specificity
  • Young Adult


  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D