Use of D-dimer and lower extremity Doppler ultrasound results to obviate the need for computerised tomographic pulmonary angiography
Annals of the Academy of Medicine, Singapore
;
: 858-863, 2006.
Article
in English
| WPRIM
| ID: wpr-275252
ABSTRACT
<p><b>UNLABELLED</b>We hypothesise that correct interpretation of other diagnostic tests could reduce the use of computerised tomographic pulmonary angiogram (CTPA) examinations in patients with suspected pulmonary embolism (PE).</p><p><b>MATERIALS AND METHODS</b>We carried out a retrospective analysis of 158 patients in a 928-bed university hospital. These consecutive patients were investigated for suspected PE from May 2001 to February 2002 using CTPA.</p><p><b>RESULTS</b>There were 74 men and 84 women with a mean (+/-SD) age of 57 (+/-19) years. Overall, 56% of patients (89/158) showed clinically significant abnormalities on the CTPA examination. The overall prevalence of PE was 15% (24/158). The D-dimers were assayed in 40% (63/158) and lower limbs were scanned with Doppler ultrasound (US) in 22% (35/158) of patients. None of the 19 patients with negative D-dimer assays had PE. Of the patients who were positively tested on Doppler US, 4 were positive and 1 was negative for PE on the CTPA. None of the patients with positive Doppler US had negative D-dimer test. In retrospect, patient management based on negative D-dimer assays and positive lower extremity Doppler US studies could have reduced the need for further investigation with CTPA by 15% (24/158).</p><p><b>CONCLUSION</b>In patients with suspected PE, correct interpretation of D-dimer and leg Doppler US tests may reduce the demand for CTPAs.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pulmonary Artery
/
Pulmonary Embolism
/
Fibrin Fibrinogen Degradation Products
/
Diagnostic Imaging
/
Angiography
/
Tomography, X-Ray Computed
/
Predictive Value of Tests
/
Retrospective Studies
/
Sensitivity and Specificity
/
Ultrasonography, Doppler
Type of study:
Diagnostic study
/
Observational study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2006
Type:
Article
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