About: D-dimer can help differentiate suspected pulmonary embolism patients that require anti-coagulation

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About: D-dimer can help differentiate suspected pulmonary embolism patients that require anti-coagulation Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	D-dimer can help differentiate suspected pulmonary embolism patients that require anti-coagulation
Creator	Mace, Sharon Nowacki, Amy Narang, Jatin Seballos, Spencer Wang, Philip
Source	PMC
abstract	OBJECTIVES: Determine whether D-dimer concentration in the absence of imaging can differentiate patients that require anti-coagulation from patients who do not require anti-coagulation. METHODS: Data was obtained retrospectively from 366 hemodynamically stable adult ED patients with suspected pulmonary embolism (PE). Patients were categorized by largest occluded artery and aggregated into: ‘Require anti-coagulation’ (main, lobar, and segmental PE), ‘Does not require anti-coagulation’ (sub-segmental and No PE), ‘High risk of deterioration’ (main and lobar PE), and ‘Not high risk of deterioration’ (segmental, sub-segmental, and No PE) groups. Wilcoxon rank-sum test was used for 2 sample comparisons of median D-dimer concentrations. Receiver operating characteristic (ROC) curve analysis was utilized to determine a D-dimer cut-off that could differentiate ‘Require anti-coagulation’ from ‘Does not require anti-coagulation’ and ‘High risk of deterioration’ from ‘Low risk of deterioration’ groups. RESULTS: The ‘Require anti-coagulation’ group had a maximum area under the curve (AUC) of 0.92 at an age-adjusted D-dimer cut-off of 1540 with a specificity of 86% (95% CI, 81–91%), and sensitivity of 84% (79–90%). The ‘High risk of deterioration’ group had a maximum AUC of 0.93 at an age-adjusted D-dimer cut-off of 2500 with a specificity of 90% (85–93%) and sensitivity of 83% (77–90%). CONCLUSIONS: An age-adjusted D-dimer cut-off of 1540 ng/mL differentiates suspected PE patients requiring anti-coagulation from those not requiring anti-coagulation. A cut-off of 2500 differentiates those with high risk of clinical deterioration from those not at high risk of deterioration. When correlated with clinical outcomes, these cut-offs can provide an objective method for clinical decision making when imaging is unavailable.
has issue date	2020-08-31(xsd:dateTime)
bibo:doi	10.1016/j.ajem.2020.08.086
has license	no-cc
schema:url	https://doi.org/10.1016/j.ajem.2020.08.086
resource representing a document's title	D-dimer can help differentiate suspected pulmonary embolism patients that require anti-coagulation
has PubMed Central identifier	PMC7456843
schema:publication	Am J Emerg Med
resource representing a document's body	covid:PMC7456843#body_text
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