The additional use of end-tidal alveolar dead space fraction following D-dimer test to improve diagnostic accuracy for pulmonary embolism in the emergency department
DC Field | Value | Language |
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dc.contributor.author | Yoon, Young Hoon | - |
dc.contributor.author | Lee, Sung Woo | - |
dc.contributor.author | Jung, Dong Min | - |
dc.contributor.author | Moon, Sung Woo | - |
dc.contributor.author | Horn, Jan Kurt | - |
dc.contributor.author | Hong, Yun-Sik | - |
dc.date.accessioned | 2021-09-08T00:31:09Z | - |
dc.date.available | 2021-09-08T00:31:09Z | - |
dc.date.created | 2021-06-14 | - |
dc.date.issued | 2010-09 | - |
dc.identifier.issn | 1472-0205 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/115770 | - |
dc.description.abstract | Purpose To determine the diagnostic performance of bedside assessment of end-tidal alveolar dead space fraction (ADSF) for pulmonary embolism (PE) and whether the use of additional ADSF assessment following D-dimer assay can improve the diagnostic accuracy in suspected PE patients in the emergency department. Methods A prospective observational study of 112 consecutive adult patients suspected of PE of whom 102 were eligible for analysis. ADSF was calculated using arterial carbon dioxide and end-tidal carbon dioxide. An ADSF less than 0.2 was considered normal. Results PE was confirmed in 11 (10.8%) of 102 patients. D-dimer assay alone as a reference standard test for PE had a sensitivity of 100%, specificity of 38.5% and false negativity of 0%. Area under the receiver-operator characteristic curve for the diagnosis of PE using ADSF values alone was 0.894, Sensitivity, specificity and false negativity for the combined results of a positive D-dimer test and abnormal ADSF were 100%, 78.0% and 0% for the presence of PE, respectively. Of 65 patients with a low or intermediate clinical probability and a positive D-dimer assay, 36 (55.4%) patients displayed normal ADSF and had no PE. Conclusions By itself ADSF assessment performed well in diagnosis of PE. The combined result of a positive D-dimer and abnormal ADSF increased the specificity for diagnosing PE compared with the D-dimer test alone. The use of additional bedside ADSF assessment following a positive D-dimer test may reduce the need for further imaging studies to detect PE in patients with a low or intermediate clinical probability. | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | BMJ PUBLISHING GROUP | - |
dc.subject | CARBON-DIOXIDE | - |
dc.subject | THROMBOEMBOLISM | - |
dc.subject | OUTPATIENTS | - |
dc.title | The additional use of end-tidal alveolar dead space fraction following D-dimer test to improve diagnostic accuracy for pulmonary embolism in the emergency department | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Lee, Sung Woo | - |
dc.contributor.affiliatedAuthor | Moon, Sung Woo | - |
dc.contributor.affiliatedAuthor | Hong, Yun-Sik | - |
dc.identifier.doi | 10.1136/emj.2008.071118 | - |
dc.identifier.scopusid | 2-s2.0-77956195306 | - |
dc.identifier.wosid | 000281389300005 | - |
dc.identifier.bibliographicCitation | EMERGENCY MEDICINE JOURNAL, v.27, no.9, pp.663 - 667 | - |
dc.relation.isPartOf | EMERGENCY MEDICINE JOURNAL | - |
dc.citation.title | EMERGENCY MEDICINE JOURNAL | - |
dc.citation.volume | 27 | - |
dc.citation.number | 9 | - |
dc.citation.startPage | 663 | - |
dc.citation.endPage | 667 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Emergency Medicine | - |
dc.relation.journalWebOfScienceCategory | Emergency Medicine | - |
dc.subject.keywordPlus | CARBON-DIOXIDE | - |
dc.subject.keywordPlus | THROMBOEMBOLISM | - |
dc.subject.keywordPlus | OUTPATIENTS | - |
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