We have located links that may give you full text access.
Role of a quantitative D-dimer assay in determining the need for CT angiography of acute pulmonary embolism.
AJR. American Journal of Roentgenology 2004 June
OBJECTIVE: Our goal was to use the results of a quantitative D-dimer assay to determine the need for pulmonary CT angiography in patients suspected of having acute pulmonary embolism.
MATERIALS AND METHODS: From July 2001 to December 2002, 755 patients underwent pulmonary CT angiography for the evaluation of acute pulmonary embolism. A rapid, fully automated quantitative D-dimer assay was obtained in more than half the patients. The electronic medical records of the patients were subsequently reviewed to analyze the negative predictive value of the D-dimer assay in the diagnostic workup of acute pulmonary embolism and to determine the outcome of the patients who had negative findings on both D-dimer assay and pulmonary CT angiography at 3-month follow-up.
RESULTS: Of the 755 patients who underwent pulmonary CT angiography, 666 (88.2%) had negative findings, 73 (9.7%) had positive findings, and 16 (2.1%) were indeterminate. A total of 426 patients underwent both pulmonary CT angiography and D-dimer level evaluation, and 84 of these had negative findings (< 0.4 microg/mL) on D-dimer assay. Eighty-two of the 84 patients with negative findings on D-dimer assay had negative findings on pulmonary CT angiography; two were indeterminate and both subsequently had low-probability ventilation-perfusion studies. Among patients with positive D-dimer assays, no one with a level between 0.4 and 1.0 microg/mL had pulmonary CT angiography with findings positive for pulmonary embolism.
CONCLUSION: A quantitative D-dimer assay was effective in excluding the need for pulmonary CT angiography and had high negative predictive value when the D-dimer level was less than 1.0 microg/mL.
MATERIALS AND METHODS: From July 2001 to December 2002, 755 patients underwent pulmonary CT angiography for the evaluation of acute pulmonary embolism. A rapid, fully automated quantitative D-dimer assay was obtained in more than half the patients. The electronic medical records of the patients were subsequently reviewed to analyze the negative predictive value of the D-dimer assay in the diagnostic workup of acute pulmonary embolism and to determine the outcome of the patients who had negative findings on both D-dimer assay and pulmonary CT angiography at 3-month follow-up.
RESULTS: Of the 755 patients who underwent pulmonary CT angiography, 666 (88.2%) had negative findings, 73 (9.7%) had positive findings, and 16 (2.1%) were indeterminate. A total of 426 patients underwent both pulmonary CT angiography and D-dimer level evaluation, and 84 of these had negative findings (< 0.4 microg/mL) on D-dimer assay. Eighty-two of the 84 patients with negative findings on D-dimer assay had negative findings on pulmonary CT angiography; two were indeterminate and both subsequently had low-probability ventilation-perfusion studies. Among patients with positive D-dimer assays, no one with a level between 0.4 and 1.0 microg/mL had pulmonary CT angiography with findings positive for pulmonary embolism.
CONCLUSION: A quantitative D-dimer assay was effective in excluding the need for pulmonary CT angiography and had high negative predictive value when the D-dimer level was less than 1.0 microg/mL.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app