D-dimer can be a useful tool in the management of patients with suspected or established venous thromboembolism (VTE). One use is in the assessment of a patient who presents with symptoms of VTE. First, a pre-test probability assessment with a validated scoring system, such as the Wells’ score, is performed by the clinician. Based on the absence or presence of a number of symptoms and signs of VTE and the presence of VTE risk factors, a patient is considered to be at low or high risk for VTE. In the low risk group, a D-dimer can then be performed. A negative result rules out VTE, making further imaging studies (e.g. venous Doppler ultrasound or chest CT scan) unnecessary. The second use of the D-dimer test is as a tool when determining the length of anticoagulation therapy necessary in a patient who has had a VTE. In patients with unprovoked or estrogen-associated VTE, a negative D-dimer – on or off anticoagulation - predicts a lower risk of recurrence, whereas a positive D-dimer predicts a higher risk. D-dimer has been incorporated into several decision tools for assessing length of anticoagulation, such as the HERDOO-2 score, the DASH-score, and the Vienna-score.

Learning Objectives:

• Discuss how D-dimer is used by clinicians in conjunction with a clinical pre-test probability assessment in the evaluation of a patient who presents with symptoms leading to suspicion of deep vein thrombosis (DVT) or pulmonary embolism (PE)
• List several of the components of the Wells’ score for the pretest probability assessment of DVT and PE
• Discuss how  D-dimer is used by clinicians to determine length of anticoagulation in patients with DVT or PE
• Discuss the risk-of-VTE-recurrence triangle and VTE recurrence risk assessment tools (e.g. HERDOO-2 score, DASH-score, Vienna score) available to clinicians for determining how long a patient should be treated with anticoagulation

LabRoots is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E. ® Program. By attending this webinar, you can earn 1 Continuing Education credit once you have viewed the webinar in its entirety.  CE credits are available for this webinar up to 2 years from the date of the live broadcast