Diagnostic value of D-Dimer assay in the diagnosis of pulmonary embolism

Objective & Hypothesis:In this study, we investigated the contribution of plasma level of D-dimer measurement to diagnosis with suspected acute pulmonary embolism in inpatients.

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Key Findings & Data:Blood samples were taken prospectively between January 1999-November 2000 for clinically suspected pulmonary embolism.

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Conclusion & Impact:As a result we concluded that there is no diagnostic value of D-dimer testing in acute pulmonary embolism because of low spesicifity.

🔬Design:Research Article

📍Scope:2000 Verileri

⚙️Variables:Tanı teknikleri · solunum sistemi · İleriye dönük çalışma

Abstract

In this study, we investigated the contribution of plasma level of D-dimer measurement to diagnosis with suspected acute pulmonary embolism in inpatients. Blood samples were taken prospectively between January 1999-November 2000 for clinically suspected pulmonary embolism. D-dimer levels were determined by semiquantitative latex agglutination as-say. Mean age was 55.88 (30-70) years in 54 cases (male: 32, female: 22). The patients were evaluated with symptom, existence of other disease, operation history, physical examination findings (blood pressure, heart rate, respiratory rate), arterial blood gas measurement, electrocardiography, chest X-ray, lower limbs Doppler ultrasonography, ventilation-perfusion scintigraphy. The definitive diagnosis were established according to clinical findings, ventilation-perfusion scintigraphy and results of the follow-up. Seventeen (31.5%) cases were diagnosed as pulmonary embolism. D-dimer was found positive in 16 of these cases (94.1%), sensitivity 94%, spesicifity 40%. As a result we concluded that there is no diagnostic value of D-dimer testing in acute pulmonary embolism because of low spesicifity. On the other hand, this test may be a useful diagnostic tool with regard to exclusion of pulmonary embolism because it is an easy and rapid method.

Özet

Bu çalışmada, akut pulmoner emboli kuşkusu olan olgularda plazma D-dimer ölçümünün tanıya katkısı araştırıldı. Ocak 1999-Kasım 2000 tarihleri arasında prospektif olarak pulmoner emboli klinik şüphesi olan olgulardan kan örnekleri alındı. Semikantitatif lateks aglütinasyon yöntemi ile D-dimer düzeyleri belirlendi. Çalışmaya alınan 54 olgunun (erkek: 32, kadın: 22) yaş ortalaması 55.88 (30-70) yıl idi. Olgular semptom, ek hastalık, operasyon öyküsü, fizik muayene bulguları (arteryel kan basıncı, kardiyak nabız, solunum sayısı), kan gazı, elektrokardiyografi, PA akciğer grafisi, alt ekstremite Doppler ultrasonografisi, ventilasyon/perfüzyon (V/Q) sintigrafisi sonuçları ile değerlendirildi. Kesin tanı, klinik bulgu, V/Q sintigrafisi ve izlem sonuçlarına göre belirlendi. Onyedi (%31.5) olgu pulmoner emboli tanısı aldı. Bu olguların 16 (%94.1)'sında D-dimer pozitif saptandı (duyarlılık %94, özgüllük %40). Sonuç olarak; D-dimer testinin özgüllüğünün düşük olması nedeni ile akut pulmoner embolide tanısal değerinin olmadığı düşünüldü. Kolay ve hızlı bir yöntem olması nedeniyle de tanıyı dışlamada yardımcı bir parametre olabileceği sonucuna varıldı.

Keywords

Tanı teknikleri solunum sistemi İleriye dönük çalışma Pulmoner emboli Diagnostic Techniques Respiratory System Prospective Studies Pulmonary Embolism

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Cite This Article

SOLAK, A. Z., TELLİ, G. C., KABAROĞLU, C., DOĞAN, B., BAYINDIR, Ü., ERDENER, D. (2003). Diagnostic value of D-Dimer assay in the diagnosis of pulmonary embolism. Solunum Hastalıkları, Cilt: 14 - Sayı: 1, 11–16. https://ajindex.com/articles/318557

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