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The diagnostic value of D-dimer with simplified Geneva score (SGS) pre-test in the diagnosis of pulmonary embolism (PE).
J Cardiothorac Surg. 2020 Jul 20; 15(1):176.JC

Abstract

BACKGROUND

Pulmonary embolism (PE) is the third most common cardiovascular syndrome with an average annual incidence rate of 77 per 100,000 population in the worldwide. The diagnose algorithms for suspected PE are generally include clinical scoring assessment and plasma D-dimer evaluation, patients with high risk of PE require computed tomographic pulmonary angiogram (CTPA) detection for confirmation.

METHODS

In this retrospective analysis, 1035 patients with suspected PE were recruited. All the patients were clinically received simplified Geneva score (SGS) pre-test, determination of plasma D-dimer level, and CTPA detection. All enrolled patients were grouped according to the CTPA results: PE patients and non-PE patients. Then, receiver operating characteristic (ROC) curve were constructed to determine the optimal D-dimer cutoff point value which is based on Yonden's index (YI).

RESULTS

294 (28.4%) patients were confirmed with PE and 741(71.6%) individuals were regarded as non-PE cases by CTPA detection. Using the SGS pre-test, 829 (80.1%) patients were classified PE-unlikely (SGS ≤ 2) and 206 (19.9%) patients were PE-likely (SGS ≥ 3). Patients with D-dimer levels above 1.96 mg/L had a significant risk to suffer from PE (area under curve (AUC), 0.707; 95% CI, 0.678-0.735; p < 0.05). Meanwhile, in patients with SGS ≥ 3, the D-dimer cutoff point value moved to 2.2 mg/L (AUC, 0.644; 95% CI, 0.574-0.709; p < 0.05).

CONCLUSION

D-dimer test in combination with SGS pre-test could improve the accuracy of PE diagnosis. Patients with D-dimer levels over 1.96 mg/L (4 times of the normal level) have a significant risk for PE. In patients with SGS ≥ 3, the D-dimer cutoff point concentration for PE risk moves to the levels of 2.2 mg/L.

Authors+Show Affiliations

Department of Respiratory, Quanzhou First Hospital Affiliated to Fujian Medical University, No. 248-252 Dongjie Street, Quanzhou, 362000, Fujian Province, China. fu_zhihui19@outlook.com.Department of Respiratory, Quanzhou First Hospital Affiliated to Fujian Medical University, No. 248-252 Dongjie Street, Quanzhou, 362000, Fujian Province, China.Department of Respiratory, Quanzhou First Hospital Affiliated to Fujian Medical University, No. 248-252 Dongjie Street, Quanzhou, 362000, Fujian Province, China.Department of Respiratory, Quanzhou First Hospital Affiliated to Fujian Medical University, No. 248-252 Dongjie Street, Quanzhou, 362000, Fujian Province, China.Department of Respiratory, Quanzhou First Hospital Affiliated to Fujian Medical University, No. 248-252 Dongjie Street, Quanzhou, 362000, Fujian Province, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32690039

Citation

Fu, Zhihui, et al. "The Diagnostic Value of D-dimer With Simplified Geneva Score (SGS) Pre-test in the Diagnosis of Pulmonary Embolism (PE)." Journal of Cardiothoracic Surgery, vol. 15, no. 1, 2020, p. 176.
Fu Z, Zhuang X, He Y, et al. The diagnostic value of D-dimer with simplified Geneva score (SGS) pre-test in the diagnosis of pulmonary embolism (PE). J Cardiothorac Surg. 2020;15(1):176.
Fu, Z., Zhuang, X., He, Y., Huang, H., & Guo, W. (2020). The diagnostic value of D-dimer with simplified Geneva score (SGS) pre-test in the diagnosis of pulmonary embolism (PE). Journal of Cardiothoracic Surgery, 15(1), 176. https://doi.org/10.1186/s13019-020-01222-y
Fu Z, et al. The Diagnostic Value of D-dimer With Simplified Geneva Score (SGS) Pre-test in the Diagnosis of Pulmonary Embolism (PE). J Cardiothorac Surg. 2020 Jul 20;15(1):176. PubMed PMID: 32690039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The diagnostic value of D-dimer with simplified Geneva score (SGS) pre-test in the diagnosis of pulmonary embolism (PE). AU - Fu,Zhihui, AU - Zhuang,Xibin, AU - He,Yueming, AU - Huang,Hong, AU - Guo,Weifeng, Y1 - 2020/07/20/ PY - 2019/12/30/received PY - 2020/07/13/accepted PY - 2020/7/22/entrez PY - 2020/7/22/pubmed PY - 2020/12/15/medline KW - Cutoff point KW - D-dimer KW - Pulmonary embolism (PE) KW - Simplified Geneva score (SGS) SP - 176 EP - 176 JF - Journal of cardiothoracic surgery JO - J Cardiothorac Surg VL - 15 IS - 1 N2 - BACKGROUND: Pulmonary embolism (PE) is the third most common cardiovascular syndrome with an average annual incidence rate of 77 per 100,000 population in the worldwide. The diagnose algorithms for suspected PE are generally include clinical scoring assessment and plasma D-dimer evaluation, patients with high risk of PE require computed tomographic pulmonary angiogram (CTPA) detection for confirmation. METHODS: In this retrospective analysis, 1035 patients with suspected PE were recruited. All the patients were clinically received simplified Geneva score (SGS) pre-test, determination of plasma D-dimer level, and CTPA detection. All enrolled patients were grouped according to the CTPA results: PE patients and non-PE patients. Then, receiver operating characteristic (ROC) curve were constructed to determine the optimal D-dimer cutoff point value which is based on Yonden's index (YI). RESULTS: 294 (28.4%) patients were confirmed with PE and 741(71.6%) individuals were regarded as non-PE cases by CTPA detection. Using the SGS pre-test, 829 (80.1%) patients were classified PE-unlikely (SGS ≤ 2) and 206 (19.9%) patients were PE-likely (SGS ≥ 3). Patients with D-dimer levels above 1.96 mg/L had a significant risk to suffer from PE (area under curve (AUC), 0.707; 95% CI, 0.678-0.735; p < 0.05). Meanwhile, in patients with SGS ≥ 3, the D-dimer cutoff point value moved to 2.2 mg/L (AUC, 0.644; 95% CI, 0.574-0.709; p < 0.05). CONCLUSION: D-dimer test in combination with SGS pre-test could improve the accuracy of PE diagnosis. Patients with D-dimer levels over 1.96 mg/L (4 times of the normal level) have a significant risk for PE. In patients with SGS ≥ 3, the D-dimer cutoff point concentration for PE risk moves to the levels of 2.2 mg/L. SN - 1749-8090 UR - https://www.unboundmedicine.com/medline/citation/32690039/The_diagnostic_value_of_D_dimer_with_simplified_Geneva_score__SGS__pre_test_in_the_diagnosis_of_pulmonary_embolism__PE__ L2 - https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-020-01222-y DB - PRIME DP - Unbound Medicine ER -