Affiliation:
1. Department of Emergency Medicine, Ereğli State Hospital, Konya, Turkey
2. Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Turkey.
3. Department of Emergency Medicine, Akdeniz University, Faculty of Medicine, Antalya, Turkey
Abstract
Aim: It is the determination of D-dimer threshold levels according to age in patients diagnosed with pulmonary embolism (PE) by pulmonary computed tomography (CT) angiography.
Material and Methods: Patients with D-dimer levels and who underwent pulmonary angiography CT between January 01, 2015, and December 30, 2019, were included in the study. The demographic characteristics of the patients, imaging reports, and 1-month mortality of the patients were evaluated retrospectively by examining the hospital information management system and patient files. Patients with missing file data and imaging and laboratory studies other than the pre-diagnosis of PE were excluded from the study.
Results: 2613 (41,9%) of the patients included in the study were male, and 362,8 (58,1%) were female. The mean age of the patients was 43.27±17.43 years. Pulmonary angiography was performed in 1507 (24,2%) patients. Of these 1507 patients, 147 (9,8%) had PE. When the 1-month mortality of 6240 patients, whose D-dimer level was requested with the preliminary diagnosis of PE, was examined, it was seen that 20 (0.3%) patients died. The 1-month mortality rate of patients with high D-dimer levels was 0.7% (17 patients), while the mortality rate of patients with normal D-dimer test results was 0.1% (3 patients). A weak but statistically significant correlation was found between the localization of the pulmonary embolism on pulmonary CT angiography and the D-dimer level spearman’s rho value of 0.251). The cut-off D-dimer value in predicting the presence of PE in all age groups was calculated as 1.34 mg/L. The cut-off values of D-dimer value to predict the presence of PE according to age ranges respectively 1.18 mg/L (80 years) was calculated as.
Conclusion: As age increases, the D-dimer cut-off value for the diagnosis of PE also increases. There is a weak but significant correlation between D-dimer level and pulmonary embolism severity.
Publisher
Emergency Medicine Association of Turkey