Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Does a Normal Age-Adjusted D-Dimer Rule Out PE?

Jacob Ortiz, Rabia Saeed, Christopher Little, Saul Schaefer

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Risk assessment for pulmonary embolism (PE) currently relies on physician judgment, clinical decision rules (CDR), and D-dimer testing. There is still controversy regarding the role of D-dimer testing in low or intermediate risk patients. The objective of the study was to define the role of clinical decision rules and D-dimer testing in patients suspected of having a PE. Records of 894 patients referred for computed tomography pulmonary angiography (CTPA) at a University medical center were analyzed. The clinical decision rules overall had an ROC of approximately 0.70, while signs of DVT had the highest ROC (0.80). A low probability CDR coupled with a negative age-adjusted D-dimer largely excluded PE. The negative predictive value (NPV) of an intermediate CDR was 86-89%, while the addition of a negative D-dimer resulted in NPVs of 94%. Thus, in patients suspected of having a PE, a low or intermediate CDR does not exclude PE; however, in patients with an intermediate CDR, a normal age-adjusted D-dimer increases the NPV.

Original languageEnglish (US)
Article number4867060
JournalBioMed Research International
Volume2017
DOIs
StatePublished - Jan 1 2017

Fingerprint

Pulmonary Embolism
Testing
Angiography
Risk assessment
Tomography
fibrin fragment D
Physicians
Lung

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

Cite this

Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism : Does a Normal Age-Adjusted D-Dimer Rule Out PE? / Ortiz, Jacob; Saeed, Rabia; Little, Christopher; Schaefer, Saul.

In: BioMed Research International, Vol. 2017, 4867060, 01.01.2017.

Research output: Contribution to journalArticle

@article{1ba727ad33b4424bb9beff8dac67fb07,
title = "Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Does a Normal Age-Adjusted D-Dimer Rule Out PE?",
abstract = "Risk assessment for pulmonary embolism (PE) currently relies on physician judgment, clinical decision rules (CDR), and D-dimer testing. There is still controversy regarding the role of D-dimer testing in low or intermediate risk patients. The objective of the study was to define the role of clinical decision rules and D-dimer testing in patients suspected of having a PE. Records of 894 patients referred for computed tomography pulmonary angiography (CTPA) at a University medical center were analyzed. The clinical decision rules overall had an ROC of approximately 0.70, while signs of DVT had the highest ROC (0.80). A low probability CDR coupled with a negative age-adjusted D-dimer largely excluded PE. The negative predictive value (NPV) of an intermediate CDR was 86-89{\%}, while the addition of a negative D-dimer resulted in NPVs of 94{\%}. Thus, in patients suspected of having a PE, a low or intermediate CDR does not exclude PE; however, in patients with an intermediate CDR, a normal age-adjusted D-dimer increases the NPV.",
author = "Jacob Ortiz and Rabia Saeed and Christopher Little and Saul Schaefer",
year = "2017",
month = "1",
day = "1",
doi = "10.1155/2017/4867060",
language = "English (US)",
volume = "2017",
journal = "BioMed Research International",
issn = "2314-6133",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism

T2 - Does a Normal Age-Adjusted D-Dimer Rule Out PE?

AU - Ortiz, Jacob

AU - Saeed, Rabia

AU - Little, Christopher

AU - Schaefer, Saul

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Risk assessment for pulmonary embolism (PE) currently relies on physician judgment, clinical decision rules (CDR), and D-dimer testing. There is still controversy regarding the role of D-dimer testing in low or intermediate risk patients. The objective of the study was to define the role of clinical decision rules and D-dimer testing in patients suspected of having a PE. Records of 894 patients referred for computed tomography pulmonary angiography (CTPA) at a University medical center were analyzed. The clinical decision rules overall had an ROC of approximately 0.70, while signs of DVT had the highest ROC (0.80). A low probability CDR coupled with a negative age-adjusted D-dimer largely excluded PE. The negative predictive value (NPV) of an intermediate CDR was 86-89%, while the addition of a negative D-dimer resulted in NPVs of 94%. Thus, in patients suspected of having a PE, a low or intermediate CDR does not exclude PE; however, in patients with an intermediate CDR, a normal age-adjusted D-dimer increases the NPV.

AB - Risk assessment for pulmonary embolism (PE) currently relies on physician judgment, clinical decision rules (CDR), and D-dimer testing. There is still controversy regarding the role of D-dimer testing in low or intermediate risk patients. The objective of the study was to define the role of clinical decision rules and D-dimer testing in patients suspected of having a PE. Records of 894 patients referred for computed tomography pulmonary angiography (CTPA) at a University medical center were analyzed. The clinical decision rules overall had an ROC of approximately 0.70, while signs of DVT had the highest ROC (0.80). A low probability CDR coupled with a negative age-adjusted D-dimer largely excluded PE. The negative predictive value (NPV) of an intermediate CDR was 86-89%, while the addition of a negative D-dimer resulted in NPVs of 94%. Thus, in patients suspected of having a PE, a low or intermediate CDR does not exclude PE; however, in patients with an intermediate CDR, a normal age-adjusted D-dimer increases the NPV.

UR - http://www.scopus.com/inward/record.url?scp=85042163265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042163265&partnerID=8YFLogxK

U2 - 10.1155/2017/4867060

DO - 10.1155/2017/4867060

M3 - Article

C2 - 29201906

AN - SCOPUS:85042163265

VL - 2017

JO - BioMed Research International

JF - BioMed Research International

SN - 2314-6133

M1 - 4867060

ER -