Utilidad del dímero D en el diagnóstico de tromboembolismo pulmonar en la Fundación Santa Fé de Bogotá

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reponame:Repositorio Institucional EdocUR

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Rodriguez Lima, David Rene; Prada Romero, Leidy Paola; Pinzón, Bibiana; Beltran, Johnny; Especialista en Medicina de Emergencias; drrodriguezl@hotmail.com
Facultad de Medicina; Universidad del Rosario
Dimero D; Embolismo pulmonar; Criterios wells; Angiotac; Fundacion santa fe de bogota::Estudio de Casos; Embolia pulmonar::Diagnostico; D-dimer; Pulmonary thromboembolism; Criteria wells; CT angiography; TROMBOSIS DE LA VENA - TRATAMIENTO; ENFERMEDADES PULMONARES; FUNDACION SANTA FE DE BOGOTA - ESTUDIO DE CASOS; EMBOLIA PULMONAR - DIAGNOSTICO
thesis / dissertation description
INTRODUCTION: The diagnosis of pulmonary thromboembolism (PTE) has been a clinical challenge despite advances in diagnostic modalities and therapeutic options, PE remains an under-diagnosed and lethal entity. The measurement of D-dimer blood, with a cutoff of 500 mcg / L, therefore is an excellent screening test for patients in the emergency department. This initial assessment should be complemented with the performance of CT angiography of the chest, a decision that must be taken early to prevent life threatening complications METHODOLOGY: We performed a retrospective study of diagnostic tests which reviewed the medical records of 109 adult patients from the Fundación Santa Fe de Bogota in whom chest CT angiography was performed with PET protocol with diagnostic probability of pulmonary embolism by low or intermediate criteria Wells and also have dimer D. We calculated the sensitivity and specificity of D-dimer given the pretest clinical probability calculated by Wells criteria, and calculated positive and negative likelihood ratio for each dimer cutoff D. RESULTS: The study showed a sensitivity of 100% for D-dimer values ¿¿less than 1100 mcg / L, in patients with low probability and sensitivity of 100% for values ¿¿less than 700 mcg / L in patients with intermediate probability. DISCUSSION: Patients with low pretest probability for Wells criteria D-dimer values ¿¿less than 1100 mcg / L and intermediate probability values ¿¿less than 700 mcg / L do not require additional studies, which decreases significantly making CT angiography care and reduce costs.