掲載種別：研究論文（学術雑誌）   出版者・発行元：Massachusetts Medical Society  

DOI： 10.1056/nejmicm2204183

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1002/emp2.12803

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/emp2.12803

掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1002/ams2.480

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ams2.480

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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その他リンク： http://link.springer.com/article/10.1186/s12245-019-0242-y/fulltext.html

総ページ数：152  

ASIN

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総ページ数：xvi, 493p   記述言語：日本語  

CiNii Books

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総ページ数：ix, 298p   記述言語：日本語  

CiNii Books

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総ページ数：vii, 645p   記述言語：日本語  

CiNii Books

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開催年月日： 2019年10月

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開催年月日： 2018年11月

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開催年月日： 2017年10月

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開催年月日： 2016年11月

会議種別：口頭発表（一般）  

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開催年月日： 2015年10月

会議種別：口頭発表（一般）  

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