Schregardus, T.M. (2016) De diagnostische waarde van de D-dimeerbepaling voor longembolieën in het Martini Ziekenhuis te Groningen. thesis, Medicine.
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Abstract
Aim: To investigate the diagnostic value of D-dimer testing for pulmonary embolism in the Martini Hospital of Groningen, in which two cutoff levels (the conventional cutoff 500 μg/l and the age-adjusted cutoff “10x age μg/l” in patients older than 50 years) will be compared. Material and methods: D-dimer results from 730 patients (age >18 years) suspected of having pulmonary embolism were analyzed. The sensitivity and specificity of the conventional and age-adjusted cutoff are calculated. Furthermore the sensitivity and specificity of both cutoff levels for specific age groups (<51 years, 51-60 years, 61-70 years, 71-80 years, >80 year) are calculated. The results of the multidetector CT-scan (MDCT) and clinical outcome (after 3 months) are used as reference test. Results: The sensitivity and specificity for the conventional cutoff were 98% and 64%, respectively and respectively 98% and 71% for the age-adjusted cutoff. The age-adjusted cutoff revealed higher specificities over all age categories: 82% versus 76% in the age category 51-60 years, 72% versus 60% in the age category 61-70 years, 49% versus 30% in the age category 71-80 years and 42% versus 16% in patients aged older than 80 years. Conclusion: The use of the age-adjusted cutoff level for D-dimer increases the specificity without modifying the sensitivity, and hence, likely reducing the overuse of imaging procedures.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Afdeling: Longgeneeskunde van het Martini Ziekenhuis te Gron and Begeleiders: and Kramer Dr. H. & and Schokker, dr. S. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/883 |
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