[Diagnostic utility of D-dimer measurement in patients with clinical suspect of pulmonary thromboembolism in the setting of an Internal Medicine Department].
BACKGROUND
The diagnosis of pulmonary thromboembolism (PTE) may be a challenge in many cases, particularly among the elderly patients.


OBJECTIVE
To establish the diagnostic utility of D-dimer measurement by a rapid semi-quantitative immunoassay (NycoCard, D-Dimer, normal value < or =0.3 mg/l) in a series of patients with suspected PTE admitted to an Internal Medicine Department.


METHODS
Retrospective review of 48 patients admitted to our Department with the clinical suspect of PTE and D-dimer assay, in whom a lung ventilation/perfusion scan was conclusive (high or normal/very low/low probability of PTE).


RESULTS
The median age of patients was 67.4 years and 79.2% were older than 60 years. For the diagnosis of PTE, the values of sensitivity, specificity, positive predictive value, and negative predictive value were 95.2%, 55.5%, 62.5% and 93.7%, respectively. When patients with potential confounding factors in the measurement of D-dimer (surgery and/or trauma in the 2 previous weeks, or neoplasm) were excluded, similar results were obtained.


CONCLUSIONS
When a normal D-dimer (< or =0.3 mg/l) measurement by a rapid semi-quantitative immunoassay (NycoCard) is obtained, the presence of PTE is very unlikely. An increased D-dimer should lead to additional complementary tests to confirm or rule out PTE. These results apply for patients aged over 60 years and are not influenced by potential confounding factors.
Calvo Romero
J M
JM
Servicio de Medicina Interna, Hospital Regional Universitario Infanta Cristina, Héroes de Cascorro 9, 3o A, 06004 Badajoz, Spain.
Pérez Miranda
M
M
Bureo Dacal
P
P
D000368:Aged; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000097:blood* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D