Key result
A presenting D-Dimer score >1000 ng/ml in patients with proven DVT was associated with a higher rate of malignancy at 1 year compared to <1000 ng/ml (33.3% vs 5.9%; p=0.0025).
Why the study?
Does a presenting D-Dimer score < 1000 ng/ml predict the absence of malignancy in patients with proven deep vein thrombosis?
Observational (n=100)
No
Does a presenting D-Dimer score < 1000 ng/ml predict the absence of malignancy in patients with proven deep vein thrombosis?
Absolute Event Rate: 33.3% vs 5.9%
p-value: p=0.0025
In patients with proven DVT, a presenting D-Dimer score of less than 1000 ng/ml serves as a strong negative predictor for concurrent or subsequent malignancy.
May support selective malignancy screening in DVT; leaves open prospective validation before practice change.
D-Dimer measurements are being increasingly used for negative prediction of deep vein thrombosis (DVT). At our institution, clinical score, D-Dimer assay, plethysmography and, if necessary, Doppler ultrasound are used to secure the diagnosis. We collected the data from 100 consecutive patients proven to have DVT. We examined their medical case notes at diagnosis for concurrent clinical conditions and one year later to look for documented evidence of malignancy. Twenty-two of the 66 patients with D-Dimers greater than 1000 ng/ml were diagnosed with a cancer compared with only 2 of the 34 patients with a presenting D-Dimer score of less than 1000 ng/ml. We propose that a D-Dimer score of less than 1000 ng/ml in proven DVT is a strong negative predictor for malignancy (p = 0.0025).
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Jones et al. (2004) conducted an observational in Deep vein thrombosis (n=100). D-Dimer > 1000 ng/ml vs. D-Dimer < 1000 ng/ml was evaluated on Documented evidence of malignancy (p=0.0025). A presenting D-Dimer score >1000 ng/ml in patients with proven DVT was associated with a higher rate of malignancy at 1 year compared to <1000 ng/ml (33.3% vs 5.9%; p=0.0025).
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