Predicting Positive D-dimer Results in Emergency Department Patients Evaluated for Possible Pulmonary Embolism

2006 ◽  
Vol 13 (5Supplement 1) ◽  
pp. S118-S119
Author(s):  
C. Kabrhel
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Emergency Department Patients ◽  
D Dimer

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

Normal D-dimer levels in emergency department patients suspected of acute pulmonary embolism

2003 ◽  
Vol 12 (1) ◽  
pp. 17-18
Author(s):  
K.L. Dunn ◽  
J.P. Wolf ◽  
D.M. Dorfman ◽  
P. Fitzpatrick ◽  
J.L. Baker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Emergency Department Patients ◽  
D Dimer

scholarly journals LO30: Prevalence of pulmonary embolism among emergency department patients with syncope: a multicenter prospective cohort study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S17-S17 ◽  
Author(s):  
V. Thiruganasambandamoorthy ◽  
M. L.A. Sivilotti ◽  
B. H. Rowe ◽  
A. D. McRae ◽  
M. Mukarram ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
The United States ◽  
Pulmonary Angiogram ◽  
Emergency Department Patients ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort ◽  
D Dimer ◽  
Combined Data

Introduction: The prevalence of pulmonary embolism (PE) among patients with syncope is understudied. Based on a recent study with an exceptionally high PE prevalence, some advocate investigating all syncope patients for PE, including those with another clear cause for their syncope. We sought to evaluate the PE prevalence among emergency department (ED) patients with syncope. Methods: We combined data from two large prospective studies enrolling adults with syncope from 17 EDs in Canada and the United States. Each study collected the results of investigations related to PE (i.e. D-dimer or ventilation-perfusion (VQ) scan, or computed tomography pulmonary angiogram (CTPA)), and 30-day adjudicated outcomes including diagnosis of PE, arrhythmia, myocardial infarction, serious hemorrhage and/or death. Results: Of the 9,091 patients (median age 66 years, 51.9% females, 39.1% hospitalized) with 30-day follow-up, 546 (6.0%) were investigated for PE: 278 (3.1%) had D-dimer, 39 (0.4%) had VQ and 347 (3.8%) patients had CTPA performed. 30-day outcomes included: 874 (9.6%) patients with any serious outcome; 0.9% deaths; and 818 (9.0%) patients with non-PE serious outcomes. Overall, 56 patients (prevalence 0.6%; 95% CI 0.5% 0.8%) were diagnosed with PE, including 8 (0.1%) of those admitted to hospital at the index presentation. Only 11 patients (0.1%) with a non-PE serious condition had a concomitant underlying PE identified. Conclusion: The prevalence of PE is very low among ED patients with syncope, including those hospitalized following syncope. While acknowledging syncope may be caused by an underlying PE, clinicians should be cautious against indiscriminate over-investigations for PE.

scholarly journals LO01: Prevalence of pulmonary embolism among Canadian emergency department patients with syncope: a multicenter prospective cohort study

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S27
Author(s):  
V. Thiruganasambandamoorthy ◽  
M. Sivilotti ◽  
A. McRae ◽  
M.A. Mukarram ◽  
S. Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Cross Sectional Study ◽  
Study Cohort ◽  
Cross Sectional ◽  
Wells Score ◽  
Emergency Department Patients ◽  
Multicenter Prospective Cohort Study ◽  
Work Up ◽  
D Dimer

Introduction: A recent cross-sectional study reported a 17.3% prevalence of pulmonary embolism (PE) among patients with syncope. However, the study had several flaws including spectrum and work-up bias with over-diagnosis due to excessive investigations. We sought to evaluate the prevalence of PE among Canadian emergency department (ED) patients presenting with syncope. Methods: We enrolled adults with syncope at 5 EDs and collected demographics, proportion of patients evaluated for suspected PE, their Wells PE score values and results of investigations [d-dimer, computed angiography (CT) of chest or ventilation-perfusion (VQ) scan]. 30-day adjudicated outcome included diagnosis of PE requiring treatment. We used descriptive statistics to report the results. Results: 4,739 patients [mean age 54.3 years, 54.4% females, and 587 (12.4%) hospitalized] were enrolled. 323 patients (6.8%) had further evaluation and investigations performed for suspected PE: 255 patients had D-dimer performed, 140 had CT chest and 17 had VQ performed. Of the 323 patients, 300 patients were low risk (Wells score ≤4) and 23 were high-risk (score >4). A total of 16 patients (0.3%) in the study cohort were diagnosed with PE: 10 patients were diagnosed in the ED, 5 patients were diagnosed while hospitalized as inpatient, and 1 patient was diagnosed on a return ED visit. Overall the prevalence of PE was 0.3% among all ED patients with syncope; and a 0.9% among those hospitalized for syncope. Conclusion: Our study shows that the prevalence of PE is very low among all patients presenting to the ED with syncope. The prevalence is also very low among those hospitalized for syncope than previously reported. While PE should be suspected and further investigations performed among syncope patients if clinically appropriate, caution should also be taken against indiscriminate over-investigations for PE.

scholarly journals Normal d-dimer levels in emergency department patients suspected of acute pulmonary embolism

2002 ◽  
Vol 40 (8) ◽  
pp. 1475-1478 ◽  
Author(s):  
Kelly L Dunn ◽  
Jonathan P Wolf ◽  
David M Dorfman ◽  
Patricia Fitzpatrick ◽  
James L Baker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Emergency Department Patients ◽  
D Dimer
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