Publishing type：Research paper (scientific journal)   Publisher：Massachusetts Medical Society  

DOI： 10.1056/nejmicm2204183

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/emp2.12803

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/emp2.12803

Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/ams2.480

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ams2.480

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

BACKGROUND: In the diagnosis of pulmonary embolism (PE), the D-dimer threshold is based on studies conducted in Western countries, where the incidence rate is 5 times higher than that in Asian countries, including Japan. If we could elevate the D-dimer threshold based on the low pre-test probability in the Japanese population, we could omit the computed tomography pulmonary angiography (CTPA) which might lead to radiation exposure and contrast-induced nephropathy. Therefore, we aimed to determine a new D-dimer threshold specific to Japanese individuals. METHODS: We conducted a retrospective cohort study at an emergency department in Japan, using medical charts collected from January 2013 to July 2017. We included patients whose D-dimer were measured for suspicion of PE with low or intermediate probability of PE and CTPA were performed. The primary outcome was failure rate of the new D-dimer threshold, defined as the rate of PE detected by CTPA among patients with D-dimer under the new threshold ranging from 1000 to 1500 μg/L by 100. The new D-dimer threshold was appropriate if the upper limit of 95% confidence interval of the failure rate of PE was approximately 3%. RESULTS: In 395 patients included, the number of patients with PE was 24 (the prevalence was 6.1%). If the D-dimer threshold was 1100 μg/L, the failure rate was 0% (0/119), the upper limit of the 95% confidence interval of the failure rate was 3.1%, and 30% (119/395) of the CTPA might be omitted. CONCLUSION: The new D-dimer threshold could safely exclude PE. This result can be generalized to other Asian populations with a lower incidence of PE. Further prospective studies will be needed.

DOI： 10.1186/s12245-019-0242-y

PubMed

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Other Link： http://link.springer.com/article/10.1186/s12245-019-0242-y/fulltext.html

Total pages：152  

ASIN

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Total pages：xvi, 493p   Language：Japanese  

CiNii Books

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Total pages：ix, 298p   Language：Japanese  

CiNii Books

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Total pages：vii, 645p   Language：Japanese  

CiNii Books

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Event date： 2019.10

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Event date： 2018.11

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Event date： 2017.10

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Event date： 2016.11

Presentation type：Oral presentation (general)  

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Event date： 2015.10

Presentation type：Oral presentation (general)  

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