What should be considered when interpreting D-dimer test results?

Updated: Nov 18, 2019
  • Author: Reka G Szigeti, MD, PhD; Chief Editor: Eric B Staros, MD  more...
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The D-dimer test has a high sensitivity but low specificity. It may be increased in association with the following:

  • Hospitalized patients

  • After surgical procedures

  • Pregnancy

  • Inflammation

  • Malignancy

  • Trauma

  • Liver disease (decreased clearance)

  • Heart disease

Venous thromboembolic diseases are common complications in patients with cancer. Therefore, it is important to keep in mind that false-negative D-dimer results more commonly occur in this patient population.

The major advantage of the D-dimer test is the excellent NPV in the appropriate clinical setting. However, since the positive predictive value (PPV) of the test is low, positive results cannot be used alone in the diagnosis of DVT/pulmonary embolism.

From a practical standpoint, the D-dimer assay only measures the neo-epitope, which is formed after the crosslinking process of the fibrin polymers by factor XIII. Therefore, although it has limited importance in the assessment of primary fibrinolysis, there is no interference with fibrinogen, if it is present in the sample.

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