Values of D-dimer test in the diagnostics of pulmonary embolism.

AIM To establish a value of D-dimer and compare findings of elevated and normal values with the golden standard, computed tomography (CT) of lungs in patients who had symptoms indicating pulmonary thromboembolism (PTE) at admission. METHODS This retrospective/prospective study was conducted at the Department of Internal Diseases of the Cantonal Hospital Zenica, Bosnia and Herzegovina. A sample included 80 patients with symptoms indicating PTE at the time of admission, D-dimers and CT scan of thoracic organs were performed. The patients were divided into two groups: 40 examinees with PTE confirmed by CT scan and 40 patients (control group) whose PTE was not confirmed by the CT scan. RESULTS Sensitivity of D-dimer according to statistical calculation was 87.5%. Specificity of D-dimer was 57.5%. The chance of a patient to have PTE in case of elevated values of D-dimer was 3.58 higher than in patients with normal D-dimer values. The positive predicative value of D-dimer was 0.54, the negative predicative value was 0.75. Test accuracy was 57.5%. Values of D-dimer >0.83 using a ROC curve and present clinical symptoms of the disease have indicated further diagnostic examination according algorithm and a need for CT scan (of thoracic organs ) CONCLUSION D-dimer is important in the diagnostics of PTE, high sensitivity and low specificity have been proven. A positive D-dimer test indicates the presence of PTE. However, the test is not reliable. In order to set a diagnosis it is necessary to visualize a blood clot by computed tomography of lungs.