A reflection on our day-to-day clinical practice: can we increase the predictability of pulmonary embolism (PE) by combining D-dimer with other biochemical variables and CXR findings?

Abstract

PE can be quite difficult to diagnose. It is relatively common and can be fatal without adequate treatment. As per NICE guideline on the management of patients with suspected PE, where patients are considered to be of lower risks for PE based on the Wells score, D-dimer can be used to stratify patients. Positivity of D-dimer subsequently influences decision on radiological imaging (CTPA/VQ). In a real-life clinical setting, there appears to be a wide variation in clinicians' interpretation of D-dimer values in the context of PE. Apart from D-dimer, other biochemical variables including CRP, WCC, neutrophils:lymphocytes and CXR findings are often included as part of the initial investigations. This study aimed to assess the diagnostic value of these variables and its influence on predictability of PE.

Efficacy and safety of low‐dose urokinase for the treatment of hemodynamically stable AECOPD patients with acute pulmonary thromboembolism

“…Acute right ventricle failure could occur when the obstruction up to 50%. Thus, the detection of NT‐proBNP and D‐dimer concentration in serum could indirectly reflect the severity degree of PTE . In our study, the results showed that the incidence of PTE in AECOPD patients was 22.9%, especially with higher occurrence rate in severe COPD subgroup.…”

“…Thus, the detection of NT-proBNP and D-dimer concentration in serum could indirectly reflect the severity degree of PTE. [28][29][30][31] In our study, the results showed that the incidence of PTE in AECOPD patients was 22.9%, especially with higher occurrence rate in severe COPD subgroup. The levels of NT-proBNP and D-dimer in AECOPD-PTE patients were higher than that in AECOPD-only group.…”