Is D-dimer Test Cost Effective and Time Sensitive for Diagnosis of Venous Thromboembolism in Emergency Department?

Background: A D-dimer assay can be used to reduce unnecessary imaging when ruling out venous thromboembolism (VTE) in the Emergency Department (ED), thus potentially reducing patient visit times and costs. Methods: This was a cross-sectional retrospective data analysis of an academic medical center ED visits between January 1 and June 30, 2019. ED visit length and VTE diagnostic cost were compared for visits with and without a D-dimer assay. The total sample size was 106 adult ED patients who were not at high risk of VTE and, of these, 27 encounters included D-dimer testing and 79 encounters did not. Outcomes were measured using independent samples t-tests to compare ED visit length and VTE diagnostic cost for ED visits with and without D-dimer tests. Results: D-dimer testing had a moderate effect upon ED visit length, but it did not correspond to differences in ED visit length or VTE diagnostic cost. Conclusions: D-dimer testing was not statistically significant in improving the ED visit length or the VTE diagnostic cost compared to imaging studies for suspected VTE cases in the ED.