Clinical probability-adjusted (CPA) D-dimer thresholds for the exclusion of venous thromboembolism (VTE) in the emergency department.

Abstract

A short review of the literature was carried out to examine the evidence supporting the use of clinical probability-adjusted (CPA) D-dimer thresholds to exclude venous thromboembolic (VTE) disease in an ED setting. Five papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that using CPA D-dimer thresholds to exclude VTE without recourse to imaging will improve the efficiency of the test, but may increase the failure rate to unacceptable levels. CPA thresholds should be used with caution on an individual basis, supported by shared decision-making.