Pulmonary embolism diagnosis with D-dimer levels and computed tomography

Background: Pulmonary embolism (PE), a common heart and blood vessel disease, causes complications such as haemodynamic instability and cardiovascular mortality. Timely diagnosis and treatment are imperative for managing this potentially life-threatening condition. Aim: The aim of this study was to...

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Main Authors: Rochelle A. Kruger, Jeanetta du Plessis, Henra Muller
Format: Article
Language:Afrikaans
Published: AOSIS 2024-12-01
Series:Health SA Gesondheid: Journal of Interdisciplinary Health Sciences
Subjects:
Online Access:https://hsag.co.za/index.php/hsag/article/view/2620
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author Rochelle A. Kruger
Jeanetta du Plessis
Henra Muller
author_facet Rochelle A. Kruger
Jeanetta du Plessis
Henra Muller
author_sort Rochelle A. Kruger
collection DOAJ
description Background: Pulmonary embolism (PE), a common heart and blood vessel disease, causes complications such as haemodynamic instability and cardiovascular mortality. Timely diagnosis and treatment are imperative for managing this potentially life-threatening condition. Aim: The aim of this study was to establish the relationship between an elevated D-dimer level and a positive computed tomography pulmonary angiogram (CTPA), which could confirm PE in patients with chest pain and suspected PE. Setting: Data were collected at a private diagnostic radiology practice located in Bloemfontein, South Africa. Methods: Data were retrospectively collected from the Picture Archiving and Communications System (PACS). Results: Of the sampled patients (n = 1219), only 16.7% were diagnosed with PE after CTPA. Approximately 14% of the D-dimer-positive patient group were diagnosed with PE and, in the D-dimer-negative patient group, approximately 20% of the patients were diagnosed with PE. Of the patients sampled, 86% were not diagnosed with PE despite having increased D-dimer values. No specific trends in the relation between elevated D-dimer levels and a positive PE diagnosis could be identified at the significance level of 0.05; a Chi-square test of independence indicated (χ2 [1, N = 995] = 1.84, p = 0.175). Conclusion: No strong relationship between elevated D-dimer levels in the blood and a positive yield of PE after CTPA; was found hence, clinical decision rules for PE workups need refining, especially to limit unnecessary CTPA referrals in this setting. Contribution: The findings suggest that PE workup at the private practice should be revised to improve the quality of service.
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2071-9736
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spelling doaj-art-db2f01a6bc194ac5be2023a275dadd272025-08-20T01:58:04ZafrAOSISHealth SA Gesondheid: Journal of Interdisciplinary Health Sciences1025-98482071-97362024-12-01290e1e610.4102/hsag.v29i0.26201201Pulmonary embolism diagnosis with D-dimer levels and computed tomographyRochelle A. Kruger0Jeanetta du Plessis1Henra Muller2Department of Clinical Sciences, Faculty of Health and Environmental Sciences, Central University of Technology, BloemfonteinDepartment of Clinical Sciences, Faculty of Health and Environmental Sciences, Central University of Technology, BloemfonteinDepartment of Clinical Sciences, Faculty of Health and Environmental Sciences, Central University of Technology, BloemfonteinBackground: Pulmonary embolism (PE), a common heart and blood vessel disease, causes complications such as haemodynamic instability and cardiovascular mortality. Timely diagnosis and treatment are imperative for managing this potentially life-threatening condition. Aim: The aim of this study was to establish the relationship between an elevated D-dimer level and a positive computed tomography pulmonary angiogram (CTPA), which could confirm PE in patients with chest pain and suspected PE. Setting: Data were collected at a private diagnostic radiology practice located in Bloemfontein, South Africa. Methods: Data were retrospectively collected from the Picture Archiving and Communications System (PACS). Results: Of the sampled patients (n = 1219), only 16.7% were diagnosed with PE after CTPA. Approximately 14% of the D-dimer-positive patient group were diagnosed with PE and, in the D-dimer-negative patient group, approximately 20% of the patients were diagnosed with PE. Of the patients sampled, 86% were not diagnosed with PE despite having increased D-dimer values. No specific trends in the relation between elevated D-dimer levels and a positive PE diagnosis could be identified at the significance level of 0.05; a Chi-square test of independence indicated (χ2 [1, N = 995] = 1.84, p = 0.175). Conclusion: No strong relationship between elevated D-dimer levels in the blood and a positive yield of PE after CTPA; was found hence, clinical decision rules for PE workups need refining, especially to limit unnecessary CTPA referrals in this setting. Contribution: The findings suggest that PE workup at the private practice should be revised to improve the quality of service.https://hsag.co.za/index.php/hsag/article/view/2620pulmonary embolismcomputed tomographyct pulmonary angiographyd-dimer levelcontrast mediumradiation dosecovid-19.
spellingShingle Rochelle A. Kruger
Jeanetta du Plessis
Henra Muller
Pulmonary embolism diagnosis with D-dimer levels and computed tomography
Health SA Gesondheid: Journal of Interdisciplinary Health Sciences
pulmonary embolism
computed tomography
ct pulmonary angiography
d-dimer level
contrast medium
radiation dose
covid-19.
title Pulmonary embolism diagnosis with D-dimer levels and computed tomography
title_full Pulmonary embolism diagnosis with D-dimer levels and computed tomography
title_fullStr Pulmonary embolism diagnosis with D-dimer levels and computed tomography
title_full_unstemmed Pulmonary embolism diagnosis with D-dimer levels and computed tomography
title_short Pulmonary embolism diagnosis with D-dimer levels and computed tomography
title_sort pulmonary embolism diagnosis with d dimer levels and computed tomography
topic pulmonary embolism
computed tomography
ct pulmonary angiography
d-dimer level
contrast medium
radiation dose
covid-19.
url https://hsag.co.za/index.php/hsag/article/view/2620
work_keys_str_mv AT rochelleakruger pulmonaryembolismdiagnosiswithddimerlevelsandcomputedtomography
AT jeanettaduplessis pulmonaryembolismdiagnosiswithddimerlevelsandcomputedtomography
AT henramuller pulmonaryembolismdiagnosiswithddimerlevelsandcomputedtomography