Prognostic Role of Alveolar-Arterial Oxygen Pressure Difference in Acute Pulmonary Embolism

Hsu, Jen Te; Chu, Chi Ming; Chang, Shih Tai; Cheng, Hui; Cheng, Nye Jan; Ho, Wan-Ching; Chung, Chang Min

doi:10.1253/circj.70.1611

Cited by 32 publications

(35 citation statements)

References 18 publications

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“…Als Signifikanzschwelle wurde ein Wert von p = 0,05 festgesetzt. [6,10,16,18,20,27,31,32,36,37,42]. Neben einer RVD ist auch ein erhöhtes kardiales Troponin (cTn) mit einer erhöhten Mortalitäts-und Komplikationsrate verbunden [6, 10, 11, 13, 16, 20, 22, 27, 31, 32, 35-37, 42, 46].…”

Section: Statistische Auswertung ▼unclassified

“…In unserer Studie waren Frauen signifikant häufiger von einem submassiven LE-Stadium betroffen als Männer mit einer mittleren PAP-Erhöhung, die annähernd 20 mmHg die der männlichen LE-Patienten überstieg. PAP-Anstieg und die Bildung einer RVD im Rahmen einer akuten LE sind durch eine relevante Einengung der Lungenarterienstrombahn durch Thrombusmaterial verursacht [6,10,16,18,36,37,42].…”

Section: Statistische Auswertung ▼unclassified

“…Einleitung ▼ Eine akute Lungenarterienembolie (LE) ist ein kardiovaskulärer Notfall mit hoher Morbidität und Mortalität [6,16,32,37,42]. Die Inzidenz einer venösen Thromboembolie (VTE = LE und/oder tiefe Venenthrombose [TVT]) ist bei Männern gering höher als bei Frauen [15,38,40].…”

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Geschlechtsspezifische Unterschiede bei hämodynamisch stabilen Patienten mit akuter Lungenarterienembolie

Keller

Beule

Schulz

et al. 2014

Dtsch med Wochenschr

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Section: Statistische Auswertung ▼unclassified

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Geschlechtsspezifische Unterschiede bei hämodynamisch stabilen Patienten mit akuter Lungenarterienembolie

Keller

Beule

Schulz

et al. 2014

Dtsch med Wochenschr

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“…4 Hemodynamic instability has been identified as an important risk factor for in-hospital mortality or escalation of treatment. 1,33,34 The present study also demonstrated the importance of SBP in the short-term prognosis of APE patients.…”

Section: Hypotension and Short-term Prognosis Of Apementioning

confidence: 99%

Prognostic Value of Arterial/Alveolar Oxygen Tension Ratio (a/APO2) in Acute Pulmonary Embolism

Hsu

Chu

Chang

et al. 2007

Circ J

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“…Acute PTE (APTE) is a cardiovascular emergency associated with high morbidity and mortality (4)(5)(6)(7)(8)(9). Computed tomography pulmonary angiogram (CTPA) is the gold standard for APTE diagnosis, with a sensitivity of 90% and a specificity of 78-100% (10)(11)(12).…”

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confidence: 99%

Clinical application of the Innovance D-dimer assay in the diagnosis of acute pulmonary thromboembolism

Bai

Huang

Song

et al. 2017

Experimental and Therapeutic Medicine

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Abstract.Patients with acute pulmonary thromboembolism (APTE) have a high short-term mortality rate. The current study aimed to investigate the use of D-dimer in the diagnosis of APTE in suspected APTE patients. All suspected APTE patients were classified into diagnosis or control groups according to the results of a computed tomography pulmonary angiogram. Mann-Whitney U and Kruskal-Wallis H tests were used to evaluate the association between D-dimer values and APTE. Area under the curve (AUC) values and the Youden Index were used to determine D-dimer cut-off levels for the prediction of APTE. The data of 112 suspected APTE patients (54.8% women; mean age, 70.5 years) were analyzed prospectively. There were no significant differences in age (74.5 vs. 73.5 years, P=0.538) or gender distribution (female ratio 56.5 vs. 53.0%, P=0.847) between the diagnosis and control groups. The incidence of symptoms including dyspnea (67.4 vs. 33.3%; P<0.01), chest distress (47.8 vs. 25.8%; P<0.05) and elevated D-dimer (8.49 vs. 0.97 mg/l; P<0.001) were significantly higher in patients with APTE compared with the control group. D-dimer values >3.32 mg/l fibrinogen equivalent units (FEU) were indicative of APTE and the Youden Index was 0.69. The maximum AUC was 0.87 (95% CI: 0.79-0.92), the sensitivity and specificity were 89.13 and 80.30%, respectively, the positive and negative likelihood ratios were 4.53 and 0.14, respectively, and the positive and negative predictive values were 75.90 and 91.40%, respectively. A D-dimer value <0.60 mg/l FEU was the optimal threshold for excluding APTE diagnosis, with a sensitivity of 100.0% and a specificity of 28.79%. The positive and negative likelihood ratios were 1.40 and 0.00, respectively, and the positive and negative predictive values were 49.50 and 100.00%, respectively. Thus, D-dimer levels, combined with clinical assessment, yield high sensitivity and specificity in diagnosing APTE. IntroductionPulmonary thromboembolism (PTE) is a pulmonary circulation dysfunction caused by thrombotic occlusion of the pulmonary artery (1-3). Acute PTE (APTE) is a cardiovascular emergency associated with high morbidity and mortality (4-9). Computed tomography pulmonary angiogram (CTPA) is the gold standard for APTE diagnosis, with a sensitivity of 90% and a specificity of 78-100% (10-12). However, CTPA is an expensive procedure and has some technical limitations, which restrains its clinical application in many hospitals. A plasma D-dimer test is commonly the first step in patient APTE risk assessment, and is considered to have clinical value (13-15).D-dimer is a soluble degradation product of crosslinked fibrin under the action of the fibrinolytic system. An elevated concentration of D-dimer is often suggestive of secondary fibrinolytic hyperthyroidism (15). The high negative predictive value of plasma D-dimer makes it an important criterion for excluding PTE diagnosis. However, since elevated concentrations of D-dimer are associated with a variety of diseases, its diagnosis specificity for PTE is ...

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Prognostic Role of Alveolar-Arterial Oxygen Pressure Difference in Acute Pulmonary Embolism

Cited by 32 publications

References 18 publications

Geschlechtsspezifische Unterschiede bei hämodynamisch stabilen Patienten mit akuter Lungenarterienembolie

Geschlechtsspezifische Unterschiede bei hämodynamisch stabilen Patienten mit akuter Lungenarterienembolie

Prognostic Value of Arterial/Alveolar Oxygen Tension Ratio (a/APO2) in Acute Pulmonary Embolism

Clinical application of the Innovance D-dimer assay in the diagnosis of acute pulmonary thromboembolism

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