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Pulmonary Vascular Disease: Pulmonary Vascular Disease: VTE |

Potential Effect of a Renal Function Adjusted D-dimer Cutoff Value to Improve the Exclusion of Pulmonary Embolism

Xin Xi, MD
Author and Funding Information

Beijing Anzhen Hospital, Capital Medical University, Beijing, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A524. doi:10.1016/j.chest.2016.02.546
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SESSION TITLE: Pulmonary Vascular Disease: VTE

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To evaluate the potential effect of a renal function adjusted D-dimer cut-off value to improve the exclusion of pulmonary embolism (PE).

METHODS: Retrospective analysis of 1784 in-patients and patients in the emergency department in Anzhen hospital from January of 2011 to June of 2013 with nonhigh probability of PE evaluated by Wells Score. The diagnoses of PE were confirmed by Computed Tomography pulmonary angiogram and ventilation-perfusion scan. Glomerular filtration rates (GFR) were estimated. Patients were divided into three subgroups according to GFR: normal renal function, mild renal impairment and moderate renal impairment. Negative D-dimer was defined as a level of age-standardized D-dimer value < 500 μg/L D-dimer levels. Proportions of patients with negative D-dimer and the usefulness of D-dimer to rule out PE were compared between three subgroups. A new D-dimer cut-off point in patients with renal impairment was developed by using receiver operating characteristics (ROC) curves and the effect of diagnostic efficiency of rule out PE with the renal function adjusted D-dimer cut-off was assessed.

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