Diagnostic accuracy of d-dimer test in diagnosing pulmonary embolism in emergency department

Abstract

Objective: To determine the diagnostic accuracy of D-dimer assay in diagnosing pulmonary embolism taking findings of CTPA as the gold standard.Study design: Retrospective Cross-sectional study Place and Duration This study was conducted in Ziauddin University Hospital Karachi from March 2022 to March 2023 Methodology: Both male and female patients aged 18 years or above presenting with chest pain and dyspnea for a duration of one hour or more were included. Blood sampling was done and the sample was drawn from the easily accessible superficial vein. CTPA was performed on a 16-slice CT scanner. Patients were positioned supine and with arms raised above the head and a scan was commenced from lung bases to apices in a single breath hold. Scans were reported on the workstation.Results: This study had 187 patients in total. The patients were 55.09 ± 12.98 years old on average. There were 132 patients (70.6%) who were over 45 years old and 55 (29.4%) who were under 45 years old. There were 92 women and 95 men in total, or 50.8% and 49.2%, respectively. There were 84 (44.9%) obese patients and 103 (55.1%) non-obese patients. The mean level of D-dimer was 2.17 ± 1.41 microgram/mlConclusion: It can be concluded that D-dimer level measurement is a safe and sensitive method for identifying pulmonary embolism. This could result in the avoidance of unnecessary exposure to ionizing radiation in the form of CTPA and may help to initiate PE treatment promptly.