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Non-high risk PE in the patients with acute or exacerbated respiratory disease: the value of the algorithm based on D-dimer evaluation and Revised Geneva Score.
- Source :
-
Pneumonologia i alergologia polska [Pneumonol Alergol Pol] 2015; Vol. 83 (6), pp. 445-52. - Publication Year :
- 2015
-
Abstract
- Introduction: The diagnostic algorithm of non-high risk pulmonary embolism (PE) is based on probability scoring systems and plasma D-dimer (DD) assessment. The aim of the present study was to investigate the efficacy of Revised Geneva Scoring (RGS) and DD testing for the excluding of non-high risk PE, in the patients admitted to the hospital due to acute respiratory diseases.<br />Material and Methods: The consecutive patients, above 18 years of age, referred to the department of lung diseases, entered the study. The exclusion criteria were: the pregnancy and the suspicion of high risk PE. Plasma DD was measured with quick ELISA test, VIDAS D-dimer New, bioMerieux, France. Multislice computed tomography angiography was performed in all of the patients.<br />Results: 153 patients, median age 65 (19-88) years entered the study. The probability of PE was: low - in 58 patients (38%), intermediate - in 90 (59%), high - in 5 (3%). DD < 500 ng/ml was found in 12% of patients with low and intermediate probability of PE. PE was recognized in 10 out of 153 patients (7%). None of the patients with DD < 500 ng/ml was diagnosed with PE (NPV 100%). Median DD value was significantly higher in PE patients comparing to non-PE (4500 ng/ml and 1356 ng/ml respectively, p = 0.006).<br />Conclusion: In the group of the patients with acute respiratory symptoms, low or intermediate clinical probability scoring combined with normal DD had a high NPV in excluding PE. Nevertheless, such approach was not very effective, as the increased DD was noted in 88% of the examined population.
- Subjects :
- Adult
Aged
Biomarkers blood
Diagnostic Errors prevention & control
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Middle Aged
Reference Values
Risk Assessment
Young Adult
Algorithms
Fibrin Fibrinogen Degradation Products analysis
Guideline Adherence statistics & numerical data
Pulmonary Embolism blood
Pulmonary Embolism diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0867-7077
- Volume :
- 83
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Pneumonologia i alergologia polska
- Publication Type :
- Academic Journal
- Accession number :
- 26559797
- Full Text :
- https://doi.org/10.5603/PiAP.2015.0073