Acute pulmonary embolism pretest probability estimation by d-dimer test, our modified, new ECG score and clinical prediction rules

We investigated whether a sufficiently sensitive D-dimer test could exclude acute pulmonary embolism (acPE) as a stand-alone diagnostic test and compared our previously published, modified ECG score with the Wells and Geneva scores in the estimation of acPE pretest probability. We retrospectively ev...

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Bibliographic Details
Published in:Heliyon 2024-09, Vol.10 (17), p.e36326, Article e36326
Main Authors: Simon, András, Ámon, Tamás, Baracsi-Botos, Viktória, Pálfi, Tímea, Szőke, Vince Bertalan, Püspöki, Zsuzsanna, Varga, Zoltán, Kiss, Loretta Zsuzsa, Szénási, Gábor, Járai, Zoltán, Vereckei, András
Format: Article
Language:English
Subjects:
Clinical prediction rules
D-dimer test
Electrocardiography
Pulmonary embolism
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Summary:We investigated whether a sufficiently sensitive D-dimer test could exclude acute pulmonary embolism (acPE) as a stand-alone diagnostic test and compared our previously published, modified ECG score with the Wells and Geneva scores in the estimation of acPE pretest probability. We retrospectively evaluated 345 patients who underwent chest CT angiography (CTA) for the suspicion of acPE. The pretest probability of acPE was assessed in 120 D-dimer negative [DD (−)] and 225 D-dimer positive [DD (+)] patients. Chest CTA verified acPE in 57/345 (16.5 %) patients and in 1/120 (0.8 %) DD (−) patient. In DD (−) patients the test accuracy (TA) and specificity (SP) of the ECG score (98 %, 99 %) were better than those of the Wells score (92.5 %, 92.4 %) (p = 0.063 and p 
ISSN:2405-8440
2405-8440
DOI:10.1016/j.heliyon.2024.e36326