Urfalioglu Ahmet Burak, Altug Ertugrul, Cinar Hayri, Aksay Erdem, Yesiloglu Onder, Cakir Adem, Avsar Mustafa, Diken Ozlem Ercen, Guven Ramazan, Avci Akkan
Department of Emergency Medicine, Health Science University, Adana City Research and Training Hospital, Kışla Mahallesi, Dr. Mithat Özsan Bulvarı, 4522. Sokak No: 28, Yüreğir/Adana, Turkey.
Department of Emergency Medicine, Health Science University, Istanbul Cam and Sakura City Research and Training Hospital, Istanbul, Turkey.
Ir J Med Sci. 2024 Dec;193(6):2695-2703. doi: 10.1007/s11845-024-03766-7. Epub 2024 Jul 30.
Pulmonary embolism requires careful differential diagnosis as it is associated with a wide range of symptoms that may suggest different diseases such as chest pain, shortness of breath and syncope. Since the disease can be fatal, especially in cases where right ventricular failure and hemodynamic instability develop, prognostic markers are great importance in terms of monitoring the patient during the treatment process.
We aimed in our study to compare the relationship between the ratio of D-dimer and High Sensitive Troponin T (HsTnT) values with short-term mortality and to compare this relationship with Pulmonary Embolism Severity Index (PESI) scoring.
Our study was conducted with patients who applied to the emergency department of our hospital between 01/01/2022 and 01/01/2023 and were definitively diagnosed with Pulmonary thromboembolism after their evaluation.
The success of D-dimer/HsTroponin, D-dimer/CK-MB and troponin/D-dimer indices calculated from the laboratory test results of the cases in predicting mortality was examined, and a comparison was made with the success of the PESI score in predicting mortality. Among these indices, D-dimer/CK-MB was found to be the most successful index in predicting 7-day mortality (AUC: 0.734; 95% CI: 0.653-0.815; p < 0.001). Additionally, the D-dimer/HsTroponin ratio was found to be statistically significant as a successful index in predicting 7-day mortality (AUC: 0.697; 95% CI: 0.621-0.774; p < 0.001).
FD-dimer/HsTroponin ratio, which is a powerful, fast, low-cost, easy and simple test, can be used especially in emergency services instead of the PESI score as a mortality marker in pulmonary embolism, which has a high mortality rate.
肺栓塞需要仔细进行鉴别诊断,因为它与多种症状相关,这些症状可能提示不同疾病,如胸痛、呼吸急促和晕厥。由于该疾病可能致命,尤其是在出现右心室衰竭和血流动力学不稳定的情况下,预后标志物在治疗过程中对监测患者至关重要。
我们的研究旨在比较D-二聚体与高敏肌钙蛋白T(HsTnT)值的比值与短期死亡率之间的关系,并将这种关系与肺栓塞严重程度指数(PESI)评分进行比较。
我们的研究是对2022年1月1日至2023年1月1日期间到我院急诊科就诊并在评估后被明确诊断为肺血栓栓塞症的患者进行的。
检查了根据病例实验室检查结果计算的D-二聚体/肌钙蛋白、D-二聚体/肌酸激酶同工酶(CK-MB)和肌钙蛋白/D-二聚体指数在预测死亡率方面的成功率,并与PESI评分预测死亡率的成功率进行了比较。在这些指数中,D-二聚体/CK-MB被发现是预测7天死亡率最成功的指数(曲线下面积[AUC]:0.734;95%置信区间[CI]:0.653 - 0.815;p < 0.001)。此外,D-二聚体/HsTnT比值作为预测7天死亡率的成功指数具有统计学意义(AUC:0.697;95% CI:0.621 - 0.774;p < 0.001)。
D-二聚体/HsTnT比值是一种强大、快速、低成本、简便的检测方法,尤其可在急诊服务中替代PESI评分,作为死亡率高的肺栓塞的死亡率标志物。