A higher D-dimer threshold for predicting pulmonary embolism in patients with COVID-19: a retrospective study.
A higher D-dimer threshold for predicting pulmonary embolism in patients with COVID-19: a retrospective study.
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DOI：
10.1007/s10140-020-01859-1
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发表时间：
2020-12
影响因子：
2.2
通讯作者：
Vicente-Bártulos A
中科院分区：
文献类型：
--
作者：
Ventura-Díaz S;Quintana-Pérez JV;Gil-Boronat A;Herrero-Huertas M;Gorospe-Sarasúa L;Montilla J;Acosta-Batlle J;Blázquez-Sánchez J;Vicente-Bártulos A
即使在没有肺栓塞（PE）的情况下，COVID-19也会提高D-二聚体（DD）水平，导致计算机断层扫描肺血管造影（CTPA）请求增加。我们的目的是确定PE阳性和PE阴性COVID-19患者的DD值之间是否存在差异，如果存在差异，则建立新的临界值，以准确确定何时需要CTPA。这项研究回顾性分析了2020年3月1日至4月30日期间在西班牙马德里的Ramón y Cajal大学医院因疑似PE接受CTPA的所有COVID-19患者。使用Student t检验比较PE阳性组和PE阴性组之间的DD水平。在ROC曲线中计算预测COVID-19患者PE风险的最佳DD截止值。242例患者被纳入研究。151例（62%）为男性，中位年龄为68岁（IQR 55-78）。在205/242例（96%）患者中检测到DD增加（中位数3260; IQR 1203-9625 ng/mL）。73/242（30%）例患者在CTPA上诊断为PE。PE阳性组（7872，IQR 3150- 22，494 ng/mL）的DD中位数显著高于PE阴性组（2009，IQR 5675- 15，705 ng/mL）（p < .001）。DD预测PE的最佳截止值为2903 ng/mL（AUC为0.76 [CI 95% 0.69-0.83]，灵敏度为81%）。总死亡率为16%（39/242）。D-二聚体的较高阈值（2903 ng/mL）可以预测COVID-19患者的PE风险，灵敏度为81%。
COVID-19 raises D-dimer (DD) levels even in the absence of pulmonary embolism (PE), resulting in an increase in computed tomography pulmonary angiogram (CTPA) requests. Our purpose is to determine whether there are differences between DD values in PE-positive and PE-negative COVID-19 patients and, if so, to establish a new cutoff value which accurately determines when a CTPA is needed. This study retrospectively analyzed all COVID-19 patients who underwent a CTPA due to suspected PE between March 1 and April 30, 2020, at Ramón y Cajal University Hospital, Madrid (Spain). DD level comparisons between PE-positive and PE-negative groups were made using Student’s t test. The optimal DD cutoff value to predict PE risk in COVID-19 patients was calculated in the ROC curve. Two hundred forty-two patients were included in the study. One hundred fifty-one (62%) were men and the median age was 68 years (IQR 55–78). An increase of DD (median 3260; IQR 1203–9625 ng/mL) was detected in 205/242 (96%) patients. 73/242 (30%) of the patients were diagnosed with PE on CTPA. The DD median value was significantly higher (p < .001) in the PE-positive group (7872, IQR 3150–22,494 ng/mL) compared with the PE-negative group (2009, IQR 5675–15,705 ng/mL). The optimal cutoff value for DD to predict PE was 2903 ng/mL (AUC was 0.76 [CI 95% 0.69–0.83], sensitivity 81%). The overall mortality rate was 16% (39/242). A higher threshold (2903 ng/mL) for D-dimer could predict the risk of PE in COVID-19 patients with a sensitivity of 81%.
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DOI：
10.1111/jth.14849
发表时间：
2020-07
期刊：
Journal of thrombosis and haemostasis : JTH
影响因子：
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作者：
通讯作者：
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DOI：
10.1111/jth.14817
发表时间：
2020-05
期刊：
Journal of thrombosis and haemostasis : JTH
影响因子：
--
作者：
通讯作者：
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影响因子：
19.7
作者：
Poyiadji N;Cormier P;Patel PY;Hadied MO;Bhargava P;Khanna K;Nadig J;Keimig T;Spizarny D;Reeser N;Klochko C;Peterson EL;Song T
通讯作者：
Song T
影响因子：
15.9
作者：
Chen, Guang;Wu, Di;Ning, Qin
通讯作者：
Ning, Qin
影响因子：
3.7
作者：
Alonso-Fernandez, Alberto;Toledo-Pons, Nuria;Sala-LlinaS, Ernest
通讯作者：
Sala-LlinaS, Ernest