Application Of Age-adjusted And Clinical Probability-adjusted D-dimer In Patients With Acute Pulmonary Embolism

Objective: To explore the application of age-adjusted D-dimer and clinical probability-adjusted D-dimer in patients with PE.Methods: From January 2018 to December 2018,702 inpatients with suspected PE(Pulmonary Embolism Assessment Low to Moderate)in Xinjiang Uygur Autonomous Region People's Hospital were selected as the research objects,and all patients were collected for the first time plasma D-dimerization in hospital.The results of physical examination,CTPA was used as the diagnosis method of PTE,and the sensitivity,specificity,positive predictive value,and negative predictive value of CDD,AADD and CPADD were calculated respectively.Results: The standard sensitivities of the three D-dimer cut-off values were above 90%,and there was no significant difference in pairwise comparison(P>0.05);the specificity of CDD was 36.50%(95% CI 31.71%-41.51 %),AADD specificity is 43.70%(95% CI38.71%-48.79%),CPADD specificity is 52.70%(95% CI 47.60%-57.75%),and the differences between AADD and CDD,CPADD and CDD,CPADD and AADD were statistically significant(P<0.05).Among patients with suspected PE aged 50 years or younger,the sensitivity and specificity of CDD were 95.65% and 48.65%,and the sensitivity and specificity of CPADD were 86.96% and 58.56%,respectively.The specificity of CPADD has improved over CDD and the sensitivity has decreased,but the differences were not statistically significant(P>0.05).In patients with suspected PE over50 years of age,the standard sensitivity of the three D-dimer cut-off values was above90%,and the difference was not statistically significant(P>0.05);the specificity of AADD and CPADD was improved compared with CDD.And the differences between AADD and CDD,CPADD and CDD,CPADD and AADD were statistically significant(P<0.05).Conclusion: Adjusting the age and clinical probability of D-dimer can increase thespecificity of D-dimer to different degrees,and maintain higher sensitivity,CPADD can obtain higher specificity,but CPADD is more suitable for Used in patients over 50 years of age.