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Medientyp:
E-Artikel
Titel:
Ruling out clinically suspected pulmonary embolism by assessment of clinical probability and D-dimer levels: a management study
Beteiligte:
Lutisan, Johan;
Marwijk Kooy, Marinus;
Kuipers, Bart;
Oostdijk, Ad;
van der Leur, Jef;
Büller, Harry;
Leclercq, Monique
Erschienen:
Georg Thieme Verlag KG, 2003
Erschienen in:Thrombosis and Haemostasis
Sprache:
Englisch
DOI:
10.1055/s-0037-1613548
ISSN:
0340-6245;
2567-689X
Entstehung:
Anmerkungen:
Beschreibung:
<jats:title>Summary</jats:title><jats:p>D-dimer test combined with clinical probability assessment has been proposed as the first step in the diagnostic work-up of patients with suspected pulmonary embolism (PE). In a prospective management study we investigated the safety and efficiency of excluding PE by a normal D-dimer combined with a low or moderate clinical probability. Of the 202 study patients this combination ruled out PE in 64 (32%) patients. The 3-month thromboembolic risk in these patients was 0% (95% CI, 0.0-5.6%).The prevalence of PE in the entire cohort was 29% (59 patients), whereas in the low, moderate and high clinical probability groups this was 25%, 26% and 50%, respectively. We conclude that ruling out suspected PE by a normal D-dimer combined with a low or moderate clinical probability appears to be a safe and efficient strategy. The accuracy of the clinical probability assessment is modest.</jats:p>