Combination of Wells clinical score and high D-dimer levels in the diagnosis of pulmonary embolism

• Main Authors: Süreyya Yılmaz, Füsun Topçu, Hadice Selimoğlu Şen, Özlem Abakay, Zülfükar Yılmaz
• Format: Article
• Language: English
• Published: Modestum Publishing LTD 2014-12-01
• Series: Journal of Clinical and Experimental Investigations
• Subjects: Pulmonary embolism; D-dimer
• Online Access: http://www.jceionline.org/upload/sayi/25/JCEI-01031.pdf

Objectives: Pulmonary embolism is a preventable disease that is sometime difficult to diagnosed, can be recurrent and has a high morbidity and mortality. The aim of our study is to investigate the contribution of d-dimer, which is noninvasive, fast, cheap and easy obtainable laboratory parameter and Wells clinical prediction scoring combination to the diagnosis of PE. Methods: In this study, PE positive 46 and negative 24 in the total 70 patients were evaluated prospectively. Initially clinical scoring system was calculated Wells and d-dimer levels were measured. The levels of d-dimer were over the normal level in all patients. Patients with PE were divided into 3 groups as massive, submassive and non-massive. All patients were performed shooting with computed tomographic pulmonary angiography. Results: Among Low-moderate, low-high and moderate-high probabilities the mean value of d-dimer did not differ significantly in the PE (+) patients. In patients with PE (-) moderate and high clinical probability were compared and the d-dimer (p = 0.036) mean value was significantly higher in the high clinical probability. In massive group the mean values levels of d-dimer were significantly higher than the non-massive group (p=0.02). Conclusion: In all cases D-dimer levels were above normal values. Nevertheless, when we compare our results with the literature did not detect significant differences. Therefore, we want to emphasize that new larger studies needed for the determination of new cut-off values of D-dimer test. J Clin Exp Invest 2014; 5 (4): 557-562