Abstract | BACKGROUND: METHODS: Overall, 161 PE patients were analyzed retrospectively, classified in 5 subgroups of thrombus burden according to clinical indications and compared regarding D-Dimer-levels. Linear regression models were computed to investigate the association between D-Dimer and the groups. In hemodynamically stable PE patients, a ROC curve was calculated to assess the effectiveness of D-Dimer for predicting RVD. RESULTS: Overall, 161 patients (60.9% females, 54.0% aged >70 years) were included in this analysis. The D-Dimer-level was associated with group-category in a univariate linear regression model (β 0.050 (95%CI 0.002-0.099), P = .043). After adjustment for age, sex, cancer, and pneumonia in a multivariate model we observed an association between D-Dimer and group-category with borderline significance (β 0.047 (95%CI 0.002-0.096), P = .058). The Kruskal-Wallis test demonstrated that D-Dimer increased significantly with higher group-category. In 129 normotensive patients, patients with RVD had significantly higher D-Dimer values compared to those without (1.73 (1.11/3.48) vs 1.17 (0.65/2.90) mg/l, P = .049). A ROC curve showed an AUC of 0.61, gender non-specific, with calculated optimal cut-off of 1.18 mg/l. Multi-variate logistic regression model confirmed an association between D-Dimer >1.18 mg/l and RVD (OR2.721 (95%CI 1.196-6.190), P = .017). CONCLUSIONS:
Thrombus burden in PE is related to elevated D-Dimer levels, and D-Dimer values >1.18 mg/l were predictive for RVD in normotensive patients. D-Dimer levels were influenced by DVT, but not by cancer, pneumonia, age, or renal impairment.
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Authors | Karsten Keller, Johannes Beule, Jörn Oliver Balzer, Wolfgang Dippold |
Journal | The American journal of emergency medicine
(Am J Emerg Med)
Vol. 36
Issue 9
Pg. 1613-1618
(09 2018)
ISSN: 1532-8171 [Electronic] United States |
PMID | 29371044
(Publication Type: Journal Article)
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Copyright | Copyright © 2018 Elsevier Inc. All rights reserved. |
Chemical References |
- Biomarkers
- Fibrin Fibrinogen Degradation Products
- fibrin fragment D
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Topics |
- Acute Disease
- Aged
- Biomarkers
(metabolism)
- Female
- Fibrin Fibrinogen Degradation Products
(metabolism)
- Humans
- Male
- Prognosis
- Pulmonary Embolism
(blood, diagnosis)
- ROC Curve
- Retrospective Studies
- Venous Thrombosis
(blood, complications)
- Ventricular Dysfunction, Right
(blood, complications)
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