DIAGNOSTIC ACCURACY OF D-DIMER ASSAY IN PULMONARY EMBOLISM USING CTPA AS GOLD STANDARD

Sadaf Aziz; Meena Junaid; Nadeem Ibrahim; Sonia Shoaib; Amian Iftikhar; Lubaina Awais

doi:10.51253/pafmj.v72i2.7420

Authors

Sadaf Aziz Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
Meena Junaid Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
Nadeem Ibrahim Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
Sonia Shoaib Temar Diagnostics, Rawalpindi Pakistan
Amian Iftikhar Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
Lubaina Awais Temar Diagnostics, Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v72i2.7420

Keywords:

CT pulmonary Angiography, D-Dimer, Pulmonary embolism, Sensitivity

Abstract

Objective: To determine the sensitivity and specificity of D-dimer assay for the diagnosis of PE in resource limited settings using CTPA as a gold standard for comparison.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Radiology, Combined Military Hospital, Peshawar, from Feb 2019 to Jul 2020.

Methodology: A sample of 114 cases of clinically suspected PE presenting in ED were collected by non-probability sampling as per QUADAS 2 domains. D-dimer and CTPA reporting done by separate teams, compilation of data by third team. Using SPSS 23.0, 2×2 contingency table was used to calculate the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of D-dimer in diagnosing PE.

Results: Age range 20-50 years (mean: 40.54 ± 5.02 years). Sixty patients were female (52.3%). D- Dimer levels for the diagnosis of PE: Sensitivity: 92.86%, specificity 89.66%, positive predictive value (PPV): 89.66% and negative predictive value (NPV): 92.86%.

Conclusion: The D-Dimer levels are significantly sensitive and specific in the diagnosis of PE: however keeping in view the high mortality of PE, diagnostic accuracy may be further improved by using D-Dimer levels in conjunction with pretest clinical probability rules.