Increasing D-dimer

[Matthew89]

Hello! So working in a hospital outside the US. Practices are different but I would assume medical treatment would kind of be the same? Have a patient with increasing D-dimer. Asked doctor what needs to be done. He said patient is already on lovenox. Is that all that we should do? 

[DavidFR, BSN, MSN, RN]

Depends on the context.

For example, many oncology patients have raised D-dimers anyway, so if trying to diagnose a pulmonary embolus, they will always be sent for an urgent angioscan. D-dimers alone are not an indication.

You need to be more specific about the actual diagnosis and context of the D-dimers being performed.

Where are you practising? Having worked in two different countries (UK and France), no, medical management is not always the same. There can be very different schools of thought.  

 

[JBMmom, MSN, NP]

D-dimer is a notoriously unhelpful lab value in many situations. It is best used to rule out a condition involving clots like a PE or DVT. However, as DavidFR already pointed out, it can be elevated in other conditions like cancer. Additionally, pregnancy, cigarette smoking, trauma, heart disease, advanced age, rheumatoid conditions or infection can cause elevated values. It was a somewhat useful endpoint in COVID 19 infections for determining severity of infection. But other than an initial value, I rarely see trending of the values in the absence of a specific indication.