D-dimer as a sensitive and a very nonspecific parameter for the diagnosis of pulmonary embolism
DOI:
https://doi.org/10.5457/ams.v54i2.773Keywords:
D-dimer, CT pulmonary angiogram, Covid-19, pulmonary embolismAbstract
Background: Since the beginning of the Covid-19 pandemic there has been an immense increase of CT pulmonary angiogram (CTPA) requests at the department of Radiology at our hospital. One of the most significant complications of Covid-19 is pulmonary embolism. The gold standard for detecting pulmonary embolism is CTPA.
Aim: The aim of this study was to evaluate if an elevated value of D-dimer in both Covid-19 and non- Covid-19 patients, is reason enough for patients to undergo CTPA.
Methods: CTPA was used for PE evaluation. PCR testing was used in order to separate patients into positive and negative Covid-19 groups. Plasma D-dimer levels were measured using the BCS XP Siemens System.
Results: There is no equivalent statistical form of changes in the values of the treated indicators (D-dimer levels, PCR tests, and PE (Pulmonary Embolism) present or not). According to the calculated Pearson’s, Spearman’s, and Kendall’s correlation coefficients, there is a very small correlation between D-dimer levels, PCR tests, and PE. Both Covid-19 and non-Covid-19 patients below the threshold of 0,5µg/mL, should not be considered for CTPA. Testing the sensitivity and specificity values at different cut-offs, provided us with an increase in specificity at higher cut-off values, but also a significant decrease in sensitivity.
Conclusions: D-dimer levels should be more often in correlation with clinical tests, since it has a low specificity for pulmonary embolism even at different cut-off values.
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