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Published in: Emergency Radiology 6/2020

01-12-2020 | Computed Tomography | Original Article

A higher D-dimer threshold for predicting pulmonary embolism in patients with COVID-19: a retrospective study

Authors: Sofía Ventura-Díaz, Juan V. Quintana-Pérez, Almudena Gil-Boronat, Marina Herrero-Huertas, Luis Gorospe-Sarasúa, José Montilla, Jóse Acosta-Batlle, Javier Blázquez-Sánchez, Agustina Vicente-Bártulos

Published in: Emergency Radiology | Issue 6/2020

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Abstract

Purpose

COVID-19 raises D-dimer (DD) levels even in the absence of pulmonary embolism (PE), resulting in an increase in computed tomography pulmonary angiogram (CTPA) requests. Our purpose is to determine whether there are differences between DD values in PE-positive and PE-negative COVID-19 patients and, if so, to establish a new cutoff value which accurately determines when a CTPA is needed.

Methods

This study retrospectively analyzed all COVID-19 patients who underwent a CTPA due to suspected PE between March 1 and April 30, 2020, at Ramón y Cajal University Hospital, Madrid (Spain). DD level comparisons between PE-positive and PE-negative groups were made using Student’s t test. The optimal DD cutoff value to predict PE risk in COVID-19 patients was calculated in the ROC curve.

Results

Two hundred forty-two patients were included in the study. One hundred fifty-one (62%) were men and the median age was 68 years (IQR 55–78). An increase of DD (median 3260; IQR 1203–9625 ng/mL) was detected in 205/242 (96%) patients. 73/242 (30%) of the patients were diagnosed with PE on CTPA. The DD median value was significantly higher (p < .001) in the PE-positive group (7872, IQR 3150–22,494 ng/mL) compared with the PE-negative group (2009, IQR 5675–15,705 ng/mL). The optimal cutoff value for DD to predict PE was 2903 ng/mL (AUC was 0.76 [CI 95% 0.69–0.83], sensitivity 81%). The overall mortality rate was 16% (39/242).

Conclusion

A higher threshold (2903 ng/mL) for D-dimer could predict the risk of PE in COVID-19 patients with a sensitivity of 81%.
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Metadata
Title
A higher D-dimer threshold for predicting pulmonary embolism in patients with COVID-19: a retrospective study
Authors
Sofía Ventura-Díaz
Juan V. Quintana-Pérez
Almudena Gil-Boronat
Marina Herrero-Huertas
Luis Gorospe-Sarasúa
José Montilla
Jóse Acosta-Batlle
Javier Blázquez-Sánchez
Agustina Vicente-Bártulos
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
Emergency Radiology / Issue 6/2020
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI
https://doi.org/10.1007/s10140-020-01859-1

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