Evaluation of d-dimer assay as a 'rule out' test patients suspected pulmonary embolism who underwent ct pulmonary angogram at Hospital Serdang in 2010 until 2013

Zahari, Ainaa Nadiah and Lui, Jin Sheng (2013) Evaluation of d-dimer assay as a 'rule out' test patients suspected pulmonary embolism who underwent ct pulmonary angogram at Hospital Serdang in 2010 until 2013. [Project Paper] (Submitted)

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Abstract

ntroduction: Pulmonary embolism(PE) is a common complication of hospitalization and contributes to 5 to 10 percent of deaths in hospitalized patients, making it one of the leading causes of preventable hospital deaths. Early diagnosis is essential as even patients with minor symptoms are at risk of recurrent pulmonary emboli. D-dimer serves as an indirect indicator of thrombotic activity, which used in conjunction with imaging studies and clinical signs and symptoms to exclude PE. Objective: To evaluate the sensitivity and specificity ofD-Dimer assay as a 'rule out' test in patients suspected Pulmonary Embolism at Hospital Serdang. Method: We reviewed a total of one hundred and ten patients suspected Pulmonary Embolism from medical records at Department of Imaging, Hospital Serdang from December 2010 until June 2013 who fulfill our criteria. Data were analyzed by SPSS version 21.The negative predictive value (NPV), positive predictive value (PPV), sensitivity and specificity of the D-dimer assay results were calculated. Result: Twenty-one patients (19.1 %) had pulmonary embolism at Computed Tomography Pulmonary Angiogram(CTPA). D-Dimer results were positive in 96 patients (87.3%). The NPV and sensitivity of D-dimer were 85.71 % and 90.48%, respectively. The specificity and PPV of D-Dimer were 13.5% and 19.8%, respectively. The sensitivity and NPV of D-Dimer combined with Well's score in low risk patients was 100%. Conclusion: This study showed D-Dimer results have high NPV and sensitivity for PE in low risk patients and, if negative, can be used to exclude PE in this population. Combining the assay with clinical symptoms and signs did substantially change NPV, PPY, sensitivity, or specificity. Keyword: Pulmonary Embolism, Well's score, D-Dimer, CT Pulmonary Angiogram

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Ms Norafizah Radzuan
Date Deposited:	21 Nov 2022 07:46
Last Modified:	16 Feb 2023 03:42
URI:	http://psaspb.upm.edu.my/id/eprint/131

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