Prognostic value of D-dimer in patients with pulmonary embolism

Détails

ID Serval
serval:BIB_2B8415250072
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prognostic value of D-dimer in patients with pulmonary embolism
Périodique
Thrombosis and Haemostasis
Auteur(s)
Aujesky D., Roy P. M., Guy M., Cornuz J., Sanchez O., Perrier A.
ISSN
0340-6245 (Print)
Statut éditorial
Publié
Date de publication
10/2006
Peer-reviewed
Oui
Volume
96
Numéro
4
Pages
478-82
Langue
anglais
Notes
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Oct
Résumé
D-dimer levels appear to be associated with the extent of the thromboembolic burden in patients with pulmonary embolism (PE). We therefore hypothesized that D-dimer levels at admission would be associated with prospective risk of mortality in patients with PE. We used data from 366 patients diagnosed with PE at four hospital emergency departments. A highly sensitive D-dimer test was prospectively performed at admission. The outcome was overall mortality within three months. We divided patients into quartiles on the basis of their D-dimer levels and compared mortality rates by quartile. We estimated sensitivity, specificity, and predictive values for mortality in the first and fourth quartile. Overall mortality was 5.2%. Patients who died had higher median D-dimer levels than patients who survived (4578 versus 2946 microg/l; p = 0.005). Mortality increased with increasing D-dimer levels, rising from 1.1% in the first quartile (<1500 microg/l) to 9.1% in the fourth quartile (>5500 microg/l) (P = 0.049). Sensitivity, specificity, and positive and negative predictive values of D-dimer levels <1500 microg/l to predict mortality were 95%, 26%, 7%, and 99%, respectively. Patients with PE who have D-dimer levels below 1500 microg/l have a very low mortality. Further studies must assess whether D-dimer, alone or combined with other prognostic instruments for PE, can be used to identify low-risk patients with PE who are potential candidates for outpatient treatment or an abbreviated hospital stay.
Mots-clé
Aged Fibrin Fibrinogen Degradation Products/*metabolism Humans Male Middle Aged Odds Ratio Predictive Value of Tests Prognosis Prospective Studies Pulmonary Embolism/*blood/mortality Risk Assessment Survival Analysis
Pubmed
Web of science
Création de la notice
25/01/2008 14:41
Dernière modification de la notice
06/04/2018 11:18
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