RT Journal Article
SR Electronic
T1 Can age-adjusted D-dimer be used to decrease the CTPA burden in a general hospital?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3118
DO 10.1183/13993003.congress-2018.PA3118
VO 52
IS suppl 62
A1 Kyra Bartolo
A1 Christine Cannataci
A1 Christopher Zammit
A1 Joelle Azzopardi
A1 Julian Cassar
A1 Paula Grech
A1 Gabriel Borg
A1 Brendan Caruana Montaldo
YR 2018
UL http://erj.ersjournals.com/content/52/suppl_62/PA3118.abstract
AB Background: While D-dimer assays are highly sensitive in diagnosing PE, their specificity is notoriously low. As D-dimer levels are known to rise with age, this leads to further reduced specificity, thus making the test less useful for exclusion of PE in older individuals.Methods: A retrospective analysis of patients who underwent investigation for PE over a 6 month period at the national general hospital of Malta, was carried out. All patients who underwent investigation by CT Pulmonary Angiography (CTPA) were identified using RiS and their scans were classified as positive or negative. The D-dimer level of each patient at time of scanning was collected using iSOFT. The age adjusted D-dimer of all patients aged >49 was calculated using the formula: age adjusted D-dimer=patient’s age multiplied by 10.Results: A total of 907 (male =419, female =488) patients underwent investigation for PE using CTPA at the Medical Imaging Department in Mater Dei Hospital between June and December 2017. 737 patients (male=351, female =386) aged >49 (mean age 71.8) had CTPA done, with 15.7% (n = 114) resulting positive.51.2% of these (n= 378 of 737) had D-dimer serum levels evaluated, a sign that the patients’ risk for PE was low(PE unlikely on Well's Score). 75. 9%(n=287) were found to have positive D-dimer and negative CTPA. 69.6% were found to have negative age-adjusted D-dimer. 10 patients with positive CTPA and positive D-dimer were found to have negative age-adjusted D dimer.Conclusion: The negative predictive value of age adjusted D-dimer is comparable to that of D dimer but has a higher positive predictive value. Age adjusted D dimer in low probability PE may help reduce unnecessary imaging investigations.FootnotesCite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA3118.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).