Utility of D-dimer Assay for Diagnosing Pulmonary Embolism: Single Institute Study.
10.3343/kjlm.2008.28.6.419
- Author:
Rojin PARK
1
;
Young Ik SEO
;
Soon Gyu YOON
;
Tae Youn CHOI
;
Jeong Won SHIN
;
Soo Taek UH
;
Yang Ki KIM
Author Information
1. Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea. rpark@hosp.sch.ac.kr
- Publication Type:Original Article ; English Abstract ; Evaluation Studies
- Keywords:
Pulmonary embolism;
D-dimer;
Clinical probability;
Negative predictive value
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Female;
Fibrin Fibrinogen Degradation Products/*analysis;
Humans;
Latex Fixation Tests;
Male;
Middle Aged;
Pulmonary Embolism/*diagnosis;
Retrospective Studies;
Sensitivity and Specificity;
Severity of Illness Index;
Venous Thrombosis/diagnosis
- From:The Korean Journal of Laboratory Medicine
2008;28(6):419-424
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Pulmonary embolism (PE) presents with diverse non-specific signs and symptoms and its diagnosis mainly depends on diagnostic imaging tests which are laborious and not cost-effective, and only a small proportion of patients with suspected PE actually have the disease. The aim of this study was to analyze the utility of D-dimer test for diagnosing PE by categorizing patients into 'PE likely' and 'PE unlikely' groups using Wells score for clinical probability. METHODS: One hundred forty consecutive patients with clinically suspected PE, in whom D-dimer and imaging tests were performed were enrolled. Dignosis of PE was made when the imaging tests were positive. Wells scores were retrospectively assigned and the dignostic utility of D-dimer test was analyzed. RESULTS: Of the 140 patients studied, D-dimer test was positive in 97 and diagnostic imaging tests revealed PE, deep vein thrombosis (DVT), and PE+DVT in 24, 3, and 7 patients, respectively. For the diagnosis of PE, D-dimer test with cutoff value of > or =230 ng/mL showed sensitivity, specificity, and negative predictive value of 96.8%, 39.6%, and 97.7%, respectively. These values were 96.3%, 37.9%, and 91.7% in 'PE likely' group (n=56), and 100%, 38.8%, and 100% in 'PE unlikely' group (n=84). Among 43 patients with D-dimer values of <230 ng/mL, only one patient was diagnosed with PE, who belonged to the 'PE likely' group. CONCLUSIONS: D-dimer test cannot be used as a stand-alone test to diagnose PE, but it can be helpful for exclusion of PE especially in 'PE unlikely' group according to Wells score.
