CC BY-NC-ND 4.0 · International Journal of Recent Surgical and Medical Sciences 2019; 05(01): 015-018
DOI: 10.1055/s-0039-1688543
Original Article
Medical and Surgical Update Society

Application of D-Dimer in Prognosis of Pulmonary Embolism

Urvashi Gupta
1  Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
,
Jagannath S. Dhadwad
1  Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
,
Prasad A. Gurjar
2  Department of Nephrology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
,
Dineshsingh Patil
1  Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
› Author Affiliations
Further Information

Publication History

Received: 09 February 2019

Accepted: 19 February 2019

Publication Date:
28 June 2019 (online)

  

Abstract

Introduction Pulmonary embolism (PE) is a relatively common cardiovascular emergency. It can lead to a variety of outcomes, from potentially reversible right ventricular failure (by occluding the pulmonary arterial bed) to eventual death. The diagnosis of PE is often missed due to its nonspecific clinical presentation.

Materials and Methods This is a descriptive cross-sectional study conducted at tertiary care center in India from October 1, 2016 to September 30, 2018, which includes 36 cases of PE. Institutional ethics committee clearance was obtained before start of the study. Written and informed consent was obtained from all patients. Patients were informed regarding purpose, procedures, risks, and benefits of the study in their own vernacular language.

Results The age-wise distribution of patients in this study showed that most patients were up to 40 years amounting to 58.4% of cases. Sex-wise distribution also showed that most patients were male (66.7%). Fifty percent of the patients had no thrombosis on Color Doppler findings of the involved limb, and 31.25% had superficial venous thrombosis. Blood investigation revealed that 94.4% patients had troponin negative and 94.4% had D-dimer positive. This study also attempted to correlate the D-dimer findings and Well's score. It can be seen that as per Well's score, 13 patients were with high probability, 18 with moderate probability, and 5 with low probability.

Conclusion This study states that D-dimer assays are highly sensitive and have a low rate of false-negative results. The assays have been found safe and effective when the clinical probability of PE is low. When the D-dimer result is negative in patients with low clinical probability of having PE, the presence of acute PE can be safely ruled out without diagnostic imaging.