D-Dimer, Quantitative
| Abbrev Code: | DD | ||
| Order Code: | LAB313 | Order Name: | D-Dimer Quantitative |
| Synonyms: | Fibrin D-Dimer; Fibrin Split Products; DD; D Dimer | ||
| Methodology: | Immuno-turbidimetric | ||
| CPT Codes: | 85379 x1 | ||
| Turnaround Time: | Performed 24 hours/day; results are reported within 3 hours. | ||
| Associated Links: | Specimen Collection and Processing for Coagulation Specimens |
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Collection Instructions
| Specimen: | Blood |
| Optimal Volume: | 2.7 mL (in 3 mL tube) - filled to fill line on the tube |
| Minimum\Peds Volume: | 1.8 mL (in 2 mL tube) - filled to fill line on the tube |
| Container: | Blue Na Citrate, 3.2% - fill to fill line on tube |
| Collection Instructions: | If the patient's hematocrit is greater than 55%, contact laboratory to obtain a special tube. If using a butterfly needle, a waste tube must be collected before the blue top. |
| After Care: | If the patient has a coagulation abnormality, apply direct pressure to the puncture site for 10 minutes; apply a pressure dressing. Instruct the patient to leave the bandage on for 12 hours. |
| Causes for Rejection: | Underfilled tubes, overfilled tubes, clotted specimens, specimens collected in 3.8% buffered citrate.
Whole blood specimen greater than 8 hours old or not processed appropriately within 8 hours of collection. |
Processing and Shipping
| Specimen Processing: | Send whole blood or platelet poor plasma. See Associated Link for additional processing instructions. |
| Shipping Instructions: | Ship whole blood specimens at room temperature. Whole blood specimens must arrive within 8 hours. If greater than 8 hrs is required for transport, follow specimen processing instructions and ship frozen plasma on dry ice. |
| Test Performed at or Referral Lab | Coagulation (Grand Itasca, Lakes, Northland, Oxboro Clinic, Range, Ridges, Southdale, St. John's, UMMC East Bank, UMMC/UMMCH-West Bank, Woodwinds) |
Interpretive
| Critical Range: | Greater than 20.0 ug/mL FEU |
| Reference Range: |
0.5 ug/mL FEU or less.
For patients 50 years of age or older, the application of age-adjusted cut-off values for D-Dimer may increase the specificity without significant effect on sensitivity. The literature suggested calculation age adjusted cut-off in ug/L = age in years x 10 ug/L. The results in this laboratory are reported as ug/mL rather than ug/L. The calculation for age adjusted cut off in ug/mL= age in years x 0.01 ug/mL. For example, the cut off for a 76 year old male is 76 x 0.01 ug/mL = 0.76 ug/mL (760 ug/L)
M Righini et al. Age adjusted D-dimer cut-off levels to rule out pulmonary embolism: The ADJUST-PE Study. JAMA 2014;311:1117-1124.
HJ Schouten et al. Diagnostic accuracy of conventional or age adjusted D-dimer cutoff values in older patients with suspected venous thromboembolism. Systemic review and meta-analysis. BMJ 2013:346:f2492.
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| Use: | This D-Dimer assay is intended for use in conjunction with a clinical pretest probability assessment model to exclude pulmonary embolism (PE) and deep vein thrombosis (DVT). The cut-off value is 0.5 ug/mL FEU.
The D-Dimer is a marker of the breakdown of a cross-linked fibrin clot (i.e., fibrinolysis) and an indirect marker of clot formation. Elevated levels of D-Dimer are present in a wide variety of disorders known to be associated with activation of coagulation. Some of these include:
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