D-Dimer Levels and Prognostic Features in Pulmonary Embolism

Abstract

Background: The aim of our study is to investigate the efficacy of D-dimer marker in patients who applied to the emergency department with a preliminary diagnosis of pulmonary embolism. 
 Materials and methods: This study was conducted retrospectively at Bursa Uludağ University Faculty of Medicine Hospital between January 2018 and December 2018. Patients whose D-dimer levels were checked considering the preliminary diagnosis of pulmonary embolism were included in the study. 
 Results: A total of 3411 patients were included in the study. In all patients, the diagnosis of PE was made by computed tomography pulmonary angiography. Examination of 1968 patients with (+) D-dimer revealed new diagnosis in 702 patients (35.67%). Pulmonary embolism was diagnosed in a total of 74 patients (10.54%) whereas the most common alternative diagnoses was 33.62% (n=236) pneumonia. On examination of 1443 patients with negative D-dimer levels, pulmonary embolism was diagnosed in 7 (3.14%) patients whereas the most common other diagnoses was 44.84% (n=100) Acute Coronary Syndrome. However, in the D-dimer positive patient group, the rate of newly diagnosed patients requiring clinical and intensive care hospitalization was found to be significantly higher. 
 Conclusion: In conclusion, even if pulmonary embolism is not detected in D-dimer positive cases, it is thought that these patients need further investigation, considering the frequency of serious conditions requiring clinical and intensive care unit admission.