D-dimer Rise,Pulmonary Hypertension,Lower Extremity Deep Vein Thrombosis In The Diagnostic Value Of Pulmonary Embolism

Objective:In China,acute pulmonary thromboembolism has a high rate of misdiagnosis,for its nonspecific clinical manifestations.Conformation of pulmonary embolism depends not only on diagnostic tests,but also on the assessment of special inspection.Among Chinese population,risk factors for pulmonary embolism,assess pulmonary embolism clinical probability using clinical symptoms and screening of patients with pulmonary embolism in time has important clinical implications.Methods: Suspected pulmonary embolism in hospitalized patients from January 2011 to December 2015 in Shanghai Ruijin Hospital were studied.Referring to pulmonary thromboembolism diagnosis and treatment guidelines Chinese Society of Respiratory Diseases credits will be developed in this study.CTPA was adopted as the gold diagnostic method.Univariate analysis of risk factors for pulmonary embolism was analyzed by Chi-square test and multivariate analysis using Logistic regression analysis to define the gold standard for the diagnosis of pulmonary embolism.Multivariate analysis of the risk factors of pulmonary embolism after the evaluation of its diagnostic efficacy.The area under the ROC curve(AUC)and the 95% confidence interval(CI)of the influencing factors of pulmonary embolism were calculated using Medcalc software.The sensitivity,specificity,positive predictive Values and negative predictions and Jordian indices.Application of Z test to compare the area under the curve.Results: From January 2011 to December 2015 during a suspected diagnosis of pulmonary embolism,according to the exclusion criteria after exclusion of the last effective cases included 140 cases by CTPA examination,73 patients diagnosed with pulmonary embolism,the comfermation rate was 52.1%.There is no difference between two groupsin age,sex,ASA score,with the disease,related symptoms.Univariate analysis showed a statistically significant six factors: DVT,pulmonary embolism triad,syncope,hypoxemia,pulmonary hypertension,elevated D-dimer.Multivariate analysis showed that DVT,pulmonary hypertension and D-dimer is elevated risk factors for pulmonary embolism.ROC analysis elevated D-dimer,pulmonary hypertension,DVT prediction area under the curve of pulmonary embolism(AUC,area under curve)were 0.624,0.673 and 0.416,a small area of the curve maximum of pulmonary hypertension,but the three diagnostic efficacy no significant difference.Conclusions:Multivariate analysis of the independent risk factors for D-dimer exceeds 500?g / L,pulmonary hypertension,DVT prediction of pulmonary embolism display.D-dimer exceeds 500?g / L,pulmonary hypertension,DVT prediction area under the curve of pulmonary embolism(AUC,area under curve)were 0.624,0.673 and 0.416,pulmonary embolism three forecast no significant difference in efficacy.