在与各种肺栓塞风险评分一起使用时，特定年龄的D-二聚体临界值对肺栓塞评估的诊断效用。

Diagnostic utility of an age-specific cut-off for d-dimer for pulmonary embolism assessment when used with various pulmonary embolism risk scores.

作者信息

Ackerly Imogen, Klim Sharon, McFarlane James, Kelly Anne-Maree

机构信息

Western Health and Joseph Epstein Centre for Emergency Medicine Research at Western Health, Sunshine Hospital, Melbourne, Victoria, Australia.

Joseph Epstein Centre for Emergency Medicine Research at Western Health, Melbourne, Victoria, Australia.

出版信息

Intern Med J. 2018 Apr;48(4):465-468. doi: 10.1111/imj.13753.

DOI:10.1111/imj.13753

PMID:29623992

Abstract

This retrospective cohort study compared the diagnostic utility (sensitivity, specificity and negative predictive value (NPV)) of the age-times-10 adjusted d-dimer cut-off used in combination with the original and simplified Well's pulmonary embolism (PE) scores and the original and simplified revised Geneva scores to identify patients in whom PE is classified as unlikely according to each score. The PE risk scores performed similarly with high sensitivity (97.6, 97.1, 96.9 and 97.1% respectively) and NPV (99.3, 99.3, 99.2 and 99.2% respectively). Each missed only one PE. The age-times-10 age-adjusted d-dimer assay cut-off performed similarly with each of the clinical risk scores tested with high sensitivity and NPV.

摘要

这项回顾性队列研究比较了年龄乘以10调整后的D-二聚体临界值与原始及简化的Wells肺栓塞（PE）评分、原始及简化的修订版Geneva评分联合使用时的诊断效用（敏感性、特异性和阴性预测值[NPV]），以识别根据各评分被归类为PE可能性不大的患者。PE风险评分的表现相似，敏感性较高（分别为97.6%、97.1%、96.9%和97.1%），NPV也较高（分别为99.3%、99.3%、99.2%和99.2%）。每种评分仅漏诊1例PE。年龄乘以10的年龄调整后D-二聚体检测临界值与所测试的每个临床风险评分的表现相似，敏感性和NPV都较高。