Latex-Enhanced Immunoassay D-dimer and Blood Gases Can Exclude Pulmonary Embolism in Low-Risk Patients Presenting to an Acute Care Setting

Hlavac, Michael; Cook, Julie; Ojala, Rob; Town, Ian; Beckert, Lutz

doi:10.1378/chest.128.4.2183

Cited by 6 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study population includes consecutive patients with symptomatic PE, confirmed by objective tests (pulmonary angiography, lung scintigraphy or helical CT), that underwent testing with a turbidimetric immunoassay test (IL Test Ddimer Ò , Instrumental Laboratory SpA, Milano, Italy) at baseline [27]. Blood specimens were obtained by phlebotomy prior to starting treatment with anticoagulants or thrombolytic agents.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

D‐dimer levels and 15‐day outcome in acute pulmonary embolism. Findings from the RIETE Registry

Lobo

Zorrilla

Aizpuru

et al. 2009

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

Summary. Background: A number of variables have been evaluated for risk stratification in patients with acute pulmonary embolism (PE). Whereas increased D‐dimer levels have been associated with mortality at 3 months, its role in predicting short‐term outcome (the period of time during which any therapeutic decision has to be taken) remains unclear. Methods: RIETE is an ongoing, prospective registry of consecutive patients with acute venous thromboembolism. We assessed the prognostic value of D‐dimer levels at baseline, measured with an automated latex agglutination test (IL Test D‐dimer®), on the 15‐day outcome in patients with acute PE. Overall mortality, fatal PE and major bleeding rates were compared by quartile. Results: As of February 2008, 1707 patients with acute PE underwent D‐dimer testing. Of these, 72 patients (4.2%) died during the first 15 days, 11 (0.6%) had recurrent PE, and 29 (1.7%) had major bleeding. Overall mortality increased with increasing D‐dimer levels, from 2.7% in the first quartile (< 1050 ng mL−1) to 7.0% in the fourth quartile (≥ 4200 ng mL−1). The rates of fatal PE and major bleeding also increased. On multivariate analysis, patients with D‐dimer levels in the fourth quartile had an increased risk for overall death (odds ratio, 1.8; 95% CI, 1.1–3.2), fatal PE (odds ratio, 2.0; 95% CI, 1.0–3.8) or major bleeding (odds ratio, 3.2; 95% CI, 1.5–7.0). Conclusions: PE patients with D‐dimer levels in the fourth quartile had an increased incidence of overall death, fatal PE and major bleeding within 15 days both before and after multivariate adjustment.

show abstract

Section: Methodsmentioning

confidence: 99%

“…testing with a turbidimetric immunoassay test (IL Test Ddimer Ò , Instrumental Laboratory SpA, Milano, Italy) at baseline [27]. Blood specimens were obtained by phlebotomy prior to starting treatment with anticoagulants or thrombolytic agents.…”

Section: Introductionmentioning

confidence: 99%

D‐dimer levels and 15‐day outcome in acute pulmonary embolism. Findings from the RIETE Registry

Lobo

Zorrilla

Aizpuru

et al. 2009

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

show abstract

“…Patients with a low pretest clinical probability for PE (none of the British Thoracic Society (BTS) guidelines major risk factors for PE, Table 1) and a negative D‐dimer (‘Simplify’) were excluded from the study according to local clinical practice 5 . This strategy has been validated by a previous study 13 . Other exclusion criteria were patients younger than 16 years, pregnancy, renal failure and documented previous allergic reaction to i.v.…”

Section: Methodsmentioning

confidence: 99%

Withholding anticoagulation after a negative computed tomography pulmonary angiogram as a stand‐alone imaging investigation: a prospective management study

Subramaniam¹,

Blair²,

Gilbert³

et al. 2007

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…Presence of PaO 2 <80 mmHg and P(A-a)O 2 >20 mmHg have been documented in some literature as the most common gas exchange abnormalities. [25][26][27] Decrease of arterial carbon dioxide partial pressure (PaCO 2 ) has been detected in patients with acute pulmonary embolism but has shown low significance value in prediction of acute pulmonary embolism. 25,27) Hypocapnea develops in patient with acute pulmonary embolism due to increased total minute ventilation while hypercapnia may occur to reflects massive embolism accompanied by marked increases in physiological dead space.…”

Section: Blood Gas Analysismentioning

confidence: 99%

“…[28][29][30][31] Different literatures documented that negative D-dimer test has effectively and safely excluded acute pulmonary embolism in patients presented with signs and symptoms of embolism. 26,31,32) However D-dimer has low specificity leading to a high rate of false-positive results. D-dimer can be elevated in advanced age, pregnancy, trauma, inflammatory states, cancer and recent major surgery, 33,34) so it is very probable that a patient will have a positive D-dimer after lung resections.…”

Section: D-dimermentioning

confidence: 99%

Postoperative Acute Pulmonary Embolism Following Pulmonary Resections

Shonyela

Shuang-qiang

Liu

et al. 2015

ATCS

View full text Add to dashboard Cite

Postoperative acute pulmonary embolism after pulmonary resections is highly fatal complication. Many literatures have documented cancer to be the highest risk factor for acute pulmonary embolism after pulmonary resections. Early diagnosis of acute pulmonary embolism is highly recommended and computed tomographic pulmonary angiography is the gold standard in diagnosis of acute pulmonary embolism. Anticoagulants and thrombolytic therapy have shown a great success in treatment of acute pulmonary embolism. Surgical therapies (embolectomy and inferior vena cava filter replacement) proved to be lifesaving but many literatures favored medical therapy as the first choice. Prophylaxis pre and post operation is highly recommended, because there were statistical significant results in different studies which supported the use of prophylaxis in prevention of acute pulmonary embolism. Having reviewed satisfactory number of literatures, it is suggested that thoroughly preoperative assessment of patient conditions, determining their risk factors complicating to pulmonary embolism and the use of appropriate prophylaxis measures are the key options to the successful minimization or eradication of acute pulmonary embolism after lung resections.

show abstract

Latex-Enhanced Immunoassay D-dimer and Blood Gases Can Exclude Pulmonary Embolism in Low-Risk Patients Presenting to an Acute Care Setting

Cited by 6 publications

References 25 publications

D‐dimer levels and 15‐day outcome in acute pulmonary embolism. Findings from the RIETE Registry

D‐dimer levels and 15‐day outcome in acute pulmonary embolism. Findings from the RIETE Registry

Withholding anticoagulation after a negative computed tomography pulmonary angiogram as a stand‐alone imaging investigation: a prospective management study

Postoperative Acute Pulmonary Embolism Following Pulmonary Resections

Contact Info

Product

Resources

About