Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

ERSEL M., Aksay E., Kiyan S., BAYRAKTAROĞLU S., Yuruktumen A., Ozsarac M., ...Daha Fazla

ANADOLU KARDIYOLOJI DERGISI-THE ANATOLIAN JOURNAL OF CARDIOLOGY, cilt.10, sa.5, ss.434-439, 2010 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 10 Sayı: 5
  • Basım Tarihi: 2010
  • Doi Numarası: 10.5152/akd.2010.142
  • Dergi Adı: ANADOLU KARDIYOLOJI DERGISI-THE ANATOLIAN JOURNAL OF CARDIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.434-439
  • Anahtar Kelimeler: Acute aortic dissection, D-dimer, fibrin degradation products, emergency department, diagnostic value of tests, MYOSIN HEAVY-CHAIN, INTERNATIONAL REGISTRY, DIAGNOSIS, SERUM, MANAGEMENT, IRAD
  • Akdeniz Üniversitesi Adresli: Hayır

Özet

Objective: To determine the diagnostic accuracy of D-dimer testing for detection of acute aortic dissection.

OBJECTIVE:

To determine the diagnostic accuracy of D-dimer testing for detection of acute aortic dissection.

METHODS:

This study is a retrospective chart review of patients who had been evaluated with suspicion of acute aortic dissection. All patients' D-dimer levels were determined prior to their further work up in the emergency department. The study was conducted in a tertiary care center between February 2006-August 2008. The D-dimer assay used was the immunoturbidimetric assay, with a normal range up to 0.246 µg/ml. Statistical analysis was accomplished using Chi-square test, Student's t-test and a receiver-operating characteristics (ROC) curve analysis.

RESULTS:

Ninety-nine patients were included in the study, 30 patients were diagnosed as having acute aortic dissection and 69 patients were evaluated in non-acute aortic dissection group. In comparison of the two groups, positive D-dimer results were found to be significantly higher in acute aortic dissection group than in non-acute aortic dissection group (p=0.001). Sensitivity of the D-dimer test in detection of acute aortic dissection was found as 96.6% and the negative predictive value of the test was 97.3%. Specificity and positive predictive value of the D-dimer test were 52.2% and 46.8%, respectively. The area under the ROC curve yielded an acceptable certainty for excluding acute aortic dissection on base of negative results (AUC: 0.764; CI 95%: 0.674-0.855; p=0.001).

CONCLUSION:

D-dimer testing is helpful for emergency physicians in detection of patients with suspected acute aortic dissection in the emergency department.