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Test Code LAB313 D-Dimer

Test Name Alias

D-Dimer r/o Pulmonary Embolism | D-Dimer vidas | D-Dimervidas | 8605

Clinical Information

Test is used to evaluate Pulmonary Embolism (PE), Deep Vein Thrombosis (DVT), and DIC.

 

It should be noted that the published studies evaluating this assay have included only Emergency Room or other outpatient presenting with new symptoms suggestive of thromboembolic disease. This assay has not been evaluated for this purpose in hospital inpatients, postoperative patients, or other patient types than those indicated.

 

Elevated D-Dimers may be seen in activation states of coagulation.  Elevated states of D-Dimer levels may be associated with the following:  DVT, DIC, hemorrhages, fibrinolysis, post-operative periods, cancer, and severe infections.  D-Dimer levels may be falsely elevated in underlying, non-thrombotic conditions common in hospitalized patients.  Cut-off value for D-dimer use in evaluation of VTE is 500 ng/mL FEU.

 

The measurement of D-Dimer should not be used as an aid in the diagnosis of VTE in patients with:

  • Therapeutic dose anticoagulant therapy for >24 hours
  • Fibrinolytic therapy within previous 7 days
  • Trauma or surgery within previous 4 weeks
  • Aortic aneurysm
  • Sepsis, severe infections, pneumonia, severe skin infections
  • Liver cirrhosis
  • Renal Failure
  • Pregnancy


The American College of Emergency Physicians, the American College of Physicians and the American Society of Hematology recommend that in patients older than 50 years with low-to-intermediate pretest probability for acute pulmonary embolism, an age-adjusted D-dimer cutoff of age x 10 (FEU units) can be used to exclude a diagnosis of PE without need for further imaging.


Ann Emerg Med. 2018;71:e59-e109 Ann Intern
Med.2015;163:701-711 Blood Adv 2018;2:3226

Icons & Photos

Collection Instructions

Specimen Collection: Blood

 

Container(s): 3.2% Na. Citrate (blue top)

Preferred Volume to Collect: 2.7 mL (full tube)

Minimum Volume to Collect: 1.8 mL (full tube)

Capillary collect ok: No

Microtainer acceptable: No

 

Collection Instructions:

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Processed Specimen: Platelet Poor Plasma

 

Centrifuge/Spin: Yes

Aliquot: Yes

 

Processing Instructions:

  • Detailed Instructions (link): Preparing Platelet Poor Plasma
  • Separate plasma into 1-2 aliquots, minimum of 0.5 mL each.
  • Freeze aliquots in plastic transport tubes immediately.

Transport Temperature:

  • Ambient (up to 4 hours in whole blood state)
  • Frozen (plasma only >4 hours)

Rejection Criteria

Hemolysis

Specimen Stability

Ambient: 4 hours

Frozen: Aliquot plasma for longer storage

Laboratory Retention: 24 hours

Test Frequency

Available 24 hours, usual TAT 1 hour.

Reference Range

0 – 500 ng/mL FEU

Performing Department

COAGULATION

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI
Spectrum Health Big Rapids Laboratory, Big Rapids, MI
Spectrum Health Blodgett Laboratory, Grand Rapids, MI
Spectrum Health Gerber Laboratory, Fremont, MI
Spectrum Health Kelsey Laboratory, Lakeview, MI
Spectrum Health Ludington Laboratory, Ludington, MI
Spectrum Health Pennock Laboratory, Hastings, MI
Spectrum Health Reed City Laboratory, Reed City, MI
Spectrum Health United Laboratory, Greenville, MI
Spectrum Health Zeeland Laboratory, Zeeland, MI

Methodology

Immunoassay turbidmetric

CPT

85379

CDM Code

80101933

Epic Test ID

1230100600

Interface Order Alias

10123

LOINC

D-Dimer Quant: 48065-7

Reviewed Date

4/30/2020