d-Dimers and Efficacy of Clinical Risk Estimation Algorithms: Sensitivity in Evaluation of Acute Pulmonary Embolism

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Abstract
OBJECTIVE. The goal of this study was to test the efficacy of clinical risk algorithms and a quantitative immunoturbidimetric d-dimer assay in the evaluation of patients undergoing pulmonary CT angiography for suspected acute pulmonary embolism.SUBJECTS AND METHODS. From April 1, 2007, to March 31, 2008, emergency department evaluations for clinically suspected pulmonary embolism were performed with the revised Geneva score, a quantitative d-dimer assay, and pulmonary CT angiography.RESULTS. Evaluations for pulmonary embolism were performed for 745 consecutively registered patients, 627 of whom were included in the study. The other 118 patients were excluded because a d-dimer assay was not performed. According to the revised Geneva score, 281 patients had low clinical probability of having pulmonary embolism; 330, intermediate probability; and 16, high probability. CT angiography showed that 28 patients had pulmonary embolism (six in the low-probability group, 17 in the intermediate-probability group, and...

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