Evidence map›Paper›PMID 39943869›Full record

Observational studyClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis

D-dimer Levels in Acute, Medically Ill, Hospitalized Patients: A Large, Prospective, Multicenter Study in the United States.

Jordan S Richardson, Carol L Clark, Aveh Bastani, Ali H Shams, Gregory J Fermann, Brian C Hiestand, Bory Kea, Sharon E Mace, W Frank Peacock, Alex Yang and 1 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jordan S RichardsonDepartment of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA.
Carol L ClarkDepartment of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA.ORCID 0000-0003-0451-5960
Aveh BastaniDepartment of Emergency Medicine, Corewell Health Beaumont Hospital-Troy, Troy, MI, USA.
Ali H ShamsDepartment of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA.
Gregory J FermannDepartment of Emergency Medicine, University of Cincinnati, Cincinnati, OH, USA.
Brian C HiestandDepartment of Emergency Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.
Bory KeaDepartment of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA.
Sharon E MaceDepartment of Emergency Medicine, Cleveland Clinic, Cleveland, OH, USA.
W Frank PeacockDepartment of Emergency Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, TX, USA.ORCID 0000-0002-2730-6742
Alex YangDepartment of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA.
James A WelkerDepartment of Medicine, Anne Arundel Medical Center, Annapolis, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe study's main aim was to determine the prevalence of elevated D-dimer levels in adult patients hospitalized for acute medical illnesses not suspected to have venous thromboembolism (VTE). The secondary aims were to determine VTE prophylaxis rates and VTE events.

methodsThis multicenter, prospective, observational study included patients who were admitted across nine US hospitals. Patients who were ≥60 years of age, admitted for an acute medical illness (nonsurgical/nontraumatic), and not suspected to have VTE (deep vein thrombosis [DVT]/pulmonary embolism [PE]) were enrolled. Current use of anticoagulation and recent major surgery were exclusion criteria. D-dimers were measured at hospital admission, and the analysis was performed at a central laboratory using the STA-Liatest D-Di test kit (Diagnostica Stago, Asnières sur Seine, France). The upper limit of normal (ULN) for D-dimer was defined as ≥500 ng/mL. Age-adjusted thresholds were calculated as age × 10 ng/mL. VTE events included symptomatic DVT (distal or proximal) or PE occurring during admission.

resultsAmong 995 patients (50.7% female; mean age, 70 ± 8 years), 74.4% (n = 740) had a D-dimer ≥ ULN, 62.2% (n = 619) had elevated age-adjusted levels, and 48.8% (n = 486) had D-dimers at least two times the ULN. The rate of VTE prophylaxis was 66.5% (n = 662); in this cohort, 1.8% (n = 18) developed a VTE.

conclusionMost hospitalized acute medically ill patients ≥60 years of age had elevated D-dimer levels on admission. Although an elevated D-dimer may be associated with VTE risk, its poor specificity indicates that it should not guide prophylaxis management without a multifactor risk assessment.

Indexed as

Fibrin Fibrinogen Degradation ProductsVenous ThromboembolismAcute DiseaseAgedAged, 80 and overFemaleHospitalizationHumansMaleMiddle AgedProspective StudiesPulmonary EmbolismUnited StatesFibrin Fibrinogen Degradation Productsfibrin fragment Dfibrinolysismedical illnessthrombin prophylaxisvenous thromboembolism

Identifiers

PMID39943869
PMCPMC11822829

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.