Criteria for the safe use of D -dimer testing in emergency department patients with suspected pulmonary embolism: A multicenter us study

2002 ◽  
Vol 39 (2) ◽  
pp. 144-152 ◽  
Author(s):  
Jeffrey A. Kline ◽  
R.Darrell Nelson ◽  
Raymond E. Jackson ◽  
D.Mark Courtney
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Suspected Pulmonary Embolism ◽  
Emergency Department Patients ◽  
D Dimer

scholarly journals Utilization of CT Pulmonary Angiography in Suspected Pulmonary Embolism in a Major Urban Emergency Department

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Adil Shujaat ◽  
Janet M. Shapiro ◽  
Edward Eden
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Clinical Information ◽  
Pulmonary Angiography ◽  
Suspected Pulmonary Embolism ◽  
Ct Pulmonary Angiography ◽  
Clinical Probability ◽  
Emergency Department Patients ◽  
One Year ◽  
D Dimer

Objectives. We conducted a study to answer 3 questions: (1) is CT pulmonary angiography (CTPA) overutilized in suspected pulmonary embolism (PE)? (2) What alternative diagnoses are provided by CTPA? (3) Can CTPA be used to evaluate right ventricular dilatation (RVD)?Methods. We retrospectively reviewed the clinical information of 231 consecutive emergency department patients who underwent CTPA for suspected PE over a one-year period.Results. The mean age of our patients was 53 years, and 58.4% were women. The prevalence of PE was 20.7%. Among the 136 patients with low clinical probability of PE, a d-dimer test was done in 54.4%, and it was normal in 24.3%; none of these patients had PE. The most common alternative findings on CTPA were emphysema (7.6%), pneumonia (7%), atelectasis (5.5%), bronchiectasis (3.8%), and congestive heart failure (3.3%). The sensitivity and negative predictive value of CTPA for (RVD) was 92% and 80%, respectively.Conclusions. PE could have been excluded without CTPA in ~1 out of 4 patients with low clinical probability of PE, if a formal assessment of probability and d-dimer test had been done. In patients without PE, CTPA did not provide an alternative diagnosis in 65%. In patients with PE, CTPA showed the potential to evaluate RVD.

Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients

CHEST Journal ◽  
2006 ◽  
Vol 129 (6) ◽  
pp. 1417-1423 ◽  
Author(s):  
Jeffrey A. Kline ◽  
Michael S. Runyon ◽  
William B. Webb ◽  
Alan E. Jones ◽  
Alice M. Mitchell
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Diagnostic Accuracy ◽  
Prospective Study ◽  
Emergency Department Patients ◽  
D Dimer
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