The relationship of D-Dimer levels with pulmonary thromboembolism.
- Author:
Felipe J NAVARRO III
;
Rollin P TABUENA
;
Ma. Daisy P TABUENA
- Publication Type:Feature Article
- Keywords:
Well's Criteria
- MeSH:
Human;
Male;
Female;
Middle Aged;
Pulmonary Thrombo- Embolism;
Venous Thrombo- Embolism
- From:
Philippine Journal of Internal Medicine
2008;46(1):7-13
- CountryPhilippines
-
Abstract:
Background: Pulmonary thromboembolism (PTE) is frequently evaluated in acute care settings. Despite this, the clinical diagnosis of PTE is difficult. Results of ventilation perfusion (V/Q) scans may be inconclusive, pulmonary angiograms (PAGs) are curbersome, involve risk, and spiral computed tomography are unavailable and expensive. Therefore, it must be emphasized that in order to improve the diagnostic work-up of patients with suspected PTE, the use of clinical score assessment (Wells criteria) and D-dimer testing in routine daily practice could be used as an alternative.Objective: This study aims to determine the relationship between d-dimer levels and Well's criteria, its relationship to different risk factors for developing pulmonary thromboembolism and to correlate the d-dimer levels to patient's outcomes.Methodology: Hemodynamically stable patients who are at risk for developing pulmonary thromboembolism are requested for D-Dimer assay. Prior to the testing, physicians completed for the pretest probability of PTE using Wells clinical model, score 6 points- high probability. Associated co-existing conditions and risk factors were taken into consideration.Results: A total of 62 patients (mean age of 55 years old., 1:1 male: : male-female ratio were enrolleed. Subjects were then classified as to low, intermediate and high risk for developing pulmonary thromboembolism based on Wells criteria.Conclusion: The study showed that the Well's criteria have a highly significant relationship with D-dimer levels. This means that the Wells criteria and D-dimer level, the higher risk it is for the patient to have pulmonary thromboembolism. This study also showed that high D-dimer levels were associated with increased hospital mortality. The combination of physician's pretest probability and D-dimer level results in a significant correlation to mortality.
