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Test Code DDIM D-DIMER, Plasma

Specimen and Container/Tube

Specimen Type: Plasma

Preferred Specimen: Light Blue Top Tube, 3.2% Sodium Citrate

Other Acceptable specimens: N/A

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: 

Collect specimen per standard collection procedure and send to laboratory immediately. 

 

NOTE: Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.

 

UCMC Offsite and UC MedLab Outreach Instructions: 

  • Collect specimen per standard collection procedure.
  • Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.
  • Centrifuge specimens at >2500 x g for 10 minutes at room temperature.
  • Carefully remove plasma from cells using a plastic transfer pipette avoiding buffy coat.
  • Aliquot removed plasma into 2 plastic tubes containing a minimum of 1.0 mL of specimen in each tube.
  • Plasma samples must then be frozen at -20oC.
  • Once solidly frozen, they must be shipped on dry ice. Samples that have thawed in transit will be rejected.

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits. 
  • Specimens that have wrong ratio of blood to anticoagulant (fill volume), clotted or grossly hemolyzed.

Reference Values

 

Test

Age

Sex

Reference Range

D-dimer

All

All

<0.40 µg/mL FEU

Critical Values

Analyte

Unit

Low

High

Age

N/A

 

 

 

 

CPT Codes

85379 

LOINC Codes

48065-7

Volume

Preferred Volume: 1.0 mL

 

Minimum Volume: 0.5 mL

Specimen Stability

Storage Temperature

Stability

Room temperature

8 hours

Refrigerated

not acceptable

Frozen

30 days

Collection Instructions

Collect specimen per standard laboratory collection procedures. 

 

NOTE: Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.

 

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

STAT Turnaround Time: 50 minutes

 

Routine Turnaround Time: 4 hours

 

Testing Schedule: 24/7

Clinical Indications

D-dimer is elevated in the setting of thrombosis. D-dimer can be used to rule out DVT/PE. D-dimer are also part of DIC scoring system.

Methodology

Latex Immunoassay

Synonyms/Keyword Search

D-DIMER

Additional Information

The literature cut-off value for exclusion of DVT/PE in adults using this assay is generally 0.5 ug/mL Fibrinogen Equivalent Units (FEU). This cut-off has not been locally validated.

 

Age-adjusted D-dimer calculations (only to be used for patients 50 years or greater) have been reported in the literature for the purpose of VTE exclusion, but are also not locally developed or validated.  Age-adjusted D-dimer can be calculated as the patient’s age multiplied by 0.01 ug/mL (10 ug/L).

 

Example: For a patient aged 68 years, the D-dimer (in UCM-utilized FEU units) would be considered normal below 0.680 μg/mL.

 

D-dimer levels are not validated for VTE exclusion in children.

 

Elevated D-dimers could be due to acute thrombosis, recent surgery, sepsis, malignancy, increased fibrinolysis associated with DIC, liver disease, and other causes. False-positives can result from high titer rheumatoid factor, heterophile, or anti mouse antibodies.

 

References:

  1. Bass AR et al. Clinical Decision Rules for Pulmonary Embolism in Hospitalized Patients: A Systematic Literature Review and Meta-analysis. Thromb Haemost. 2017. 117(11):2176-2185. PMID: 29044295.
  2. Schouten HJ et al. Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis. BMJ. 2013. 346:f2492. PMID: 23645857.
  3. Freund Y et al. Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With Suspected Pulmonary Embolism: A Randomized Clinical Trial. JAMA. 2021 Dec 7;326(21):2141-2149. PMID: 34874418
  4. De Pooter N, Brionne-François M, Smahi M, Abecassis L, Toulon P. Age-adjusted D-dimer cut-off levels to rule out venous thromboembolism in patients with non-high pre-test probability: Clinical performance and cost-effectiveness analysis. J Thromb Haemost. 2021 May;19(5):1271-1282. doi: 10.1111/jth.15278. Epub 2021 Mar 22. PMID: 33638267.
  5. Toulon P, Berruyer M, Brionne-François M, Grand F, Lasne D, Telion C, Arcizet J, Giacomello R, De Pooter N. Age dependency for coagulation parameters in paediatric populations. Results of a multicentre study aimed at defining the age-specific reference ranges. Thromb Haemost. 2016 Jul 4;116(1):9-16. doi: 10.1160/TH15-12-0964. Epub 2016 Mar 17. PMID: 26988943.

 

 

3.2% sodium citrate light blue top tubes must have 9 to 1 ratio of blood to anticoagulant.

Last Review Date

03/06/2024

Test Components

D-Dimer