Prediction of the severity of pulmonary embolism according to clinical pre-test and D-dimer concentration
E. T. Passalidou, E. A. G. Millioni, D. M. Mermigkis, K. E. Paschalaki, N. A. Karagiannidis, V. S. Polychronopoulos (Athens, Greece)
Source: Annual Congress 2006 - Pulmonary hypertension: thromo-embolic processes
Session: Pulmonary hypertension: thromo-embolic processes
Session type: Thematic Poster Session
Number: 2367
Disease area: Pulmonary vascular diseases
Abstract Aim: To determine the correlation between clinical Pre-test score and D-dimer concentration with the extent of pulmonary embolism (PE).Material-Method: 37 inpatients were studied with acute PE. 24 men and 13 women, mean age 70±12 years old from 2004-05. The diagnosis of PE was confirmed by spiral CT-scan or ventilation-perfusion scintigraphy. Patients were classified into those with low, moderate and high clinical probability according to specific Well‘s criteria (Pre-test). D-dimer was assayed by a rapid quantitative ELISA assay. The extent of PE was classified into 2 categories: limited (perfusion defects< 50% of the total lung area) and extensive (perfusion defects>50% of the total lung area). The main symptoms were dyspnea (80%), chest pain (40%) and dizziness (30%). DVT was documented in 14 patients (38%), malignancy in 12 (32%) and previous surgical operation in 11(30%).Results: 4 patients had low grade Pre-test, 20 moderate and 13 high grade. A negative D-dimer result was defined in 1 patient all the rest 36 had positive results (plasma concentration 150 to 1875 μg/l). Pulmonary embolism was detected in 32 patients by spiral CT-scan and 5 by ventilation-perfusion scintigraphy. The extent of PE was less than 50% in 18 patients and more than 50% in 19. Ten out of these 13 patients with high grade Pre-test had extensive PE. There was no relation of D-dimer value to the clinical Pre-test and extent of PE.Conclusions: 1. Pre-test can predict those patients with PE that have the greatest percentage of perfusion defects (p=0,058). 2. D-dimer can not predict the extent of PE. 3. There is no statistically important difference between D-dimer concentration and extent of PE.
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E. T. Passalidou, E. A. G. Millioni, D. M. Mermigkis, K. E. Paschalaki, N. A. Karagiannidis, V. S. Polychronopoulos (Athens, Greece). Prediction of the severity of pulmonary embolism according to clinical pre-test and D-dimer concentration. Eur Respir J 2006; 28: Suppl. 50, 2367
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