J Korean Soc Emerg Med.  2010 Feb;21(1):28-34.

Diagnostic Usefulness of a Relative Increase in the Ratio Between D-dimer and C-reactive Protein in Pulmonary Thromboembolism Disorder

• Lee DW
• Sim MS
• Jo IJ
• Song HG

Abstract

PURPOSE
In spite of its high sensitivity, the D-dimer test has a limited role in diagnosis of pulmonary thromboembolism (PTE) due to its low specificity. This study was designed to evaluate the diagnostic accuracy of an index for PTE with addition of C-reactive protein (CRP) in patients showing increased D-dimer level.
METHODS
We carried out a retrospective study in a tertiary emergency department and enrolled patients who did blood sampling for D-dimer and CRP at the same time among patients suspected of PTE between December 2000 and October 2008. PTE was confirmed by imaging studies, chest computed tomography and angiography. We analyzed D-dimer and CRP levels and correlated them with PTE.
RESULTS
A total of 362 patients were enrolled; 67 had PTE. Areas under the curve (AUC) of the Receiver Operating Characteristic (ROC) curve of D-dimer for PTE were smaller than those for a relative increase in the ratio of D-dimer to CRP (RDDCRP).
CONCLUSION
The diagnostic accuracy of D-dimer for PTE can be increased by normalizing D-dimer levels to CRP levels.

Keyword

Fibrin fragment D; C-reactive protein; Pulmonary Embolism; Diagnosis

MeSH Terms

Angiography
C-Reactive Protein
Emergencies
Fibrin Fibrinogen Degradation Products
Humans
Pulmonary Embolism
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Thorax
C-Reactive Protein
Fibrin Fibrinogen Degradation Products