Muhammad Ashraf Kasi, Mukhtar Mehboob, Samina Naz, Rubina Naz, Muhammad Zubair.
Diagnostic Yield of D-dimer In Pulmonary Embolism.
J Surg Pak Jan ;19(2):50-3.

Objective: To determine the diagnostic yield of D-dimer in combination with multi-detector computed tomography (MDCT) in patients with clinical symptoms and signs of acute pulmonary embolism. Study design: Cross sectional observational study. Place & Duration of study: This study was carried out in Radiology Department Rashid Hospital Dubai UAE, from October 2011 to September 2012. Methodology: In patients with clinical symptoms and signs of acute pulmonary embolism, D-dimer and MDCT were performed. Pulmonary angiography was performed to compare the results. For descriptive purpose the patients were divided into four groups. The sensitivity, specificity, false positive rate, false negative rate, positive predictive value and negative predictive value were calculated. Results: There were total of 151 patients of whom 97 (64.2%) were males and 54 (35.8%) females. The mean age of the patients was 47.26 + 16.16 year. Shortness of breath was noted in 104 (68.9%, p = 0.000), chest pain in 88 (58.3%, p = 0.042) and cyanosis in 57 (37.7%, p= 0.061) patients. The D-dimer test was positive in 80 (53.0%) patients while CT angiogram in 56 (37.1%) patients. In 52 patients both D-dimer and MDCT angiogram were positive, while 65 patients had normal D-dimer and CT angiogram. The sensitivity of D-dimer in combination with CT angiogram was 92.85%, specificity 68.42%, false positive rate 31.57%, false negative rate 7.14%, positive predictive value 63.41%, negative predictive value 94.20% and accuracy 77.48%. Conclusion: D-dimer is an easy, non-invasive, safe, efficient and cost effective method of diagnosis in clinically suspected cases of pulmonary embolism.

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