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Non-high risk PE in the patients with acute or exacerbated respiratory disease: the value of the algorithm based on D-dimer evaluation and Revised Geneva Score.
Pneumonol Alergol Pol. 2015; 83(6):445-52.PA

Abstract

INTRODUCTION

The diagnostic algorithm of non-high risk pulmonary embolism (PE) is based on probability scoring systems and plasma D-dimer (DD) assessment. The aim of the present study was to investigate the efficacy of Revised Geneva Scoring (RGS) and DD testing for the excluding of non-high risk PE, in the patients admitted to the hospital due to acute respiratory diseases.

MATERIAL AND METHODS

The consecutive patients, above 18 years of age, referred to the department of lung diseases, entered the study. The exclusion criteria were: the pregnancy and the suspicion of high risk PE. Plasma DD was measured with quick ELISA test, VIDAS D-dimer New, bioMerieux, France. Multislice computed tomography angiography was performed in all of the patients.

RESULTS

153 patients, median age 65 (19-88) years entered the study. The probability of PE was: low - in 58 patients (38%), intermediate - in 90 (59%), high - in 5 (3%). DD < 500 ng/ml was found in 12% of patients with low and intermediate probability of PE. PE was recognized in 10 out of 153 patients (7%). None of the patients with DD < 500 ng/ml was diagnosed with PE (NPV 100%). Median DD value was significantly higher in PE patients comparing to non-PE (4500 ng/ml and 1356 ng/ml respectively, p = 0.006).

CONCLUSION

In the group of the patients with acute respiratory symptoms, low or intermediate clinical probability scoring combined with normal DD had a high NPV in excluding PE. Nevertheless, such approach was not very effective, as the increased DD was noted in 88% of the examined population.

Authors+Show Affiliations

1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland. monika.szturmowicz@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26559797

Citation

Szturmowicz, Monika, et al. "Non-high Risk PE in the Patients With Acute or Exacerbated Respiratory Disease: the Value of the Algorithm Based On D-dimer Evaluation and Revised Geneva Score." Pneumonologia I Alergologia Polska, vol. 83, no. 6, 2015, pp. 445-52.
Szturmowicz M, Kacprzak A, Wyrostkiewicz D, et al. Non-high risk PE in the patients with acute or exacerbated respiratory disease: the value of the algorithm based on D-dimer evaluation and Revised Geneva Score. Pneumonol Alergol Pol. 2015;83(6):445-52.
Szturmowicz, M., Kacprzak, A., Wyrostkiewicz, D., Lewandowska, K., Jędrych, M., Bartoszuk, I., Kober, J., Burakowska, B., Barańska, I., Małek, G., & Kuś, J. (2015). Non-high risk PE in the patients with acute or exacerbated respiratory disease: the value of the algorithm based on D-dimer evaluation and Revised Geneva Score. Pneumonologia I Alergologia Polska, 83(6), 445-52. https://doi.org/10.5603/PiAP.2015.0073
Szturmowicz M, et al. Non-high Risk PE in the Patients With Acute or Exacerbated Respiratory Disease: the Value of the Algorithm Based On D-dimer Evaluation and Revised Geneva Score. Pneumonol Alergol Pol. 2015;83(6):445-52. PubMed PMID: 26559797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-high risk PE in the patients with acute or exacerbated respiratory disease: the value of the algorithm based on D-dimer evaluation and Revised Geneva Score. AU - Szturmowicz,Monika, AU - Kacprzak,Aneta, AU - Wyrostkiewicz,Dorota, AU - Lewandowska,Katarzyna, AU - Jędrych,Małgorzata, AU - Bartoszuk,Iwona, AU - Kober,Jarosław, AU - Burakowska,Barbara, AU - Barańska,Inga, AU - Małek,Grzegorz, AU - Kuś,Jan, PY - 2015/11/10/received PY - 2015/11/10/accepted PY - 2015/11/13/entrez PY - 2015/11/13/pubmed PY - 2016/6/18/medline KW - d-dimer KW - probability assessment KW - pulmonary embolism KW - respiratory diseases SP - 445 EP - 52 JF - Pneumonologia i alergologia polska JO - Pneumonol Alergol Pol VL - 83 IS - 6 N2 - INTRODUCTION: The diagnostic algorithm of non-high risk pulmonary embolism (PE) is based on probability scoring systems and plasma D-dimer (DD) assessment. The aim of the present study was to investigate the efficacy of Revised Geneva Scoring (RGS) and DD testing for the excluding of non-high risk PE, in the patients admitted to the hospital due to acute respiratory diseases. MATERIAL AND METHODS: The consecutive patients, above 18 years of age, referred to the department of lung diseases, entered the study. The exclusion criteria were: the pregnancy and the suspicion of high risk PE. Plasma DD was measured with quick ELISA test, VIDAS D-dimer New, bioMerieux, France. Multislice computed tomography angiography was performed in all of the patients. RESULTS: 153 patients, median age 65 (19-88) years entered the study. The probability of PE was: low - in 58 patients (38%), intermediate - in 90 (59%), high - in 5 (3%). DD < 500 ng/ml was found in 12% of patients with low and intermediate probability of PE. PE was recognized in 10 out of 153 patients (7%). None of the patients with DD < 500 ng/ml was diagnosed with PE (NPV 100%). Median DD value was significantly higher in PE patients comparing to non-PE (4500 ng/ml and 1356 ng/ml respectively, p = 0.006). CONCLUSION: In the group of the patients with acute respiratory symptoms, low or intermediate clinical probability scoring combined with normal DD had a high NPV in excluding PE. Nevertheless, such approach was not very effective, as the increased DD was noted in 88% of the examined population. SN - 0867-7077 UR - https://www.unboundmedicine.com/medline/citation/26559797/Non_high_risk_PE_in_the_patients_with_acute_or_exacerbated_respiratory_disease:_the_value_of_the_algorithm_based_on_D_dimer_evaluation_and_Revised_Geneva_Score_ L2 - https://journals.viamedica.pl/pneumonologia_i_alergologia_pol/article/view/43865 DB - PRIME DP - Unbound Medicine ER -