Comparison of four D-dimer assays in the context of venous thromboembolism in the emergency department

IF 2.2 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology Pub Date : 2024-05-08 DOI:10.1111/ijlh.14302

Fabio Del Ben, Elisabetta Fontanini, Gabriella Azzarini, Marina Arini, Christian Marini, Giovanni Poli, Paola Pradella, Serena Parusso, Liliana Santarossa, Federica Targa, Lorena Zardo, Roberta Giacomello, Benedetto Morelli

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引用次数: 0

Abstract

Introduction

This observational study conducted across seven emergency care units compares the efficacy of four D-dimer detection methods, namely HemosIL D-dimer HS (HS), HemosIL D-dimer HS-500 (HS-500), VIDAS D-dimer (VIDAS), and HemosIL AcuStar D-dimer (ACUSTAR). The primary focus is on patients with a clinical suspicion of deep venous thrombosis (DVT) or pulmonary embolism (PE).

Methods

A total of 149 samples were collected from patients with suspected DVT or PE. The confirmation of DVT/PE was based on calf ultrasound or computed tomography-Angiography. Direct comparisons were made between the different detection methods, considering both their analytical performance and clinical utility. Additionally, the impact of an age-adjusted cut-off on the diagnostic accuracy of each method was assessed.

Results

The results revealed comparable negative predictive value, sensitivity, and specificity across the methods, with a notable exception of increased specificity for HS compared with HS-500 (50.8% vs. 41.5%, p = 0.03). Further analysis incorporating an age-adjusted cut-off demonstrated a significant improvement in specificity for HS. When using the age-adjusted cut-off, HS exhibited a substantial increase in specificity compared with HS-500 (63.1% vs. 49.2%, p = 0.004) and demonstrated significantly higher specificity compared with VIDAS (63.1% vs. 53.8%, p = 0.04).

Conclusion

The study emphasizes the nonuniversal effect of an age-adjusted cut-off and discusses the potential necessity for different cut-off values, particularly in the case of HS-500. These findings contribute to the understanding of D-dimer detection methods in the context of DVT and PE, providing insights into their relative performances and the potential optimization through age-adjusted cut-offs.

查看原文本刊更多论文

比较急诊科静脉血栓栓塞四种 D-二聚体测定法。

简介：这项观察性研究在七家急诊室进行，比较了四种 D-二聚体检测方法的疗效：这项观察性研究在七个急诊科进行，比较了四种D-二聚体检测方法的效果，即HemosIL D-dimer HS（HS）、HemosIL D-dimer HS-500（HS-500）、VIDAS D-二聚体（VIDAS）和HemosIL AcuStar D-二聚体（ACUSTAR）。主要针对临床怀疑深静脉血栓（DVT）或肺栓塞（PE）的患者：方法：从疑似深静脉血栓或肺栓塞患者身上共采集了 149 份样本。方法：从疑似深静脉血栓（DVT）或肺栓塞（PE）患者身上共采集了 149 份样本，通过小腿超声波或计算机断层扫描--血管造影术确认深静脉血栓/肺栓塞。考虑到不同检测方法的分析性能和临床实用性，对其进行了直接比较。此外，还评估了年龄调整截断点对每种方法诊断准确性的影响：结果：结果显示各种方法的阴性预测值、灵敏度和特异性相当，但HS的特异性明显高于HS-500（50.8% vs. 41.5%，p = 0.03）。采用年龄调整截断值进行的进一步分析表明，HS 的特异性显著提高。与 HS-500 相比，使用年龄调整临界值时，HS 的特异性大幅提高（63.1% vs. 49.2%，p = 0.004），与 VIDAS 相比，HS 的特异性显著提高（63.1% vs. 53.8%，p = 0.04）：该研究强调了年龄调整截断值的非普遍效应，并讨论了不同截断值的潜在必要性，尤其是在 HS-500 的情况下。这些研究结果有助于人们了解 D-二聚体检测方法在深静脉血栓形成和 PE 中的应用，有助于深入了解这些方法的相对性能以及通过年龄调整临界值进行优化的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Laboratory Hematology 医学-血液学

CiteScore

4.50

自引率

6.70%

发文量

211

审稿时长

6-12 weeks

期刊介绍： The International Journal of Laboratory Hematology provides a forum for the communication of new developments, research topics and the practice of laboratory haematology. The journal publishes invited reviews, full length original articles, and correspondence. The International Journal of Laboratory Hematology is the official journal of the International Society for Laboratory Hematology, which addresses the following sub-disciplines: cellular analysis, flow cytometry, haemostasis and thrombosis, molecular diagnostics, haematology informatics, haemoglobinopathies, point of care testing, standards and guidelines. The journal was launched in 2006 as the successor to Clinical and Laboratory Hematology, which was first published in 1979. An active and positive editorial policy ensures that work of a high scientific standard is reported, in order to bridge the gap between practical and academic aspects of laboratory haematology.