A retrospective investigation of the relationship between D-dimer levels, prognostic features and current comorbidities of patients WHO applied to the emergency department with preliminary diagnosis of pulmonary embolism

The aim of our study is to investigate the efficacy of D-dimer marker in patients who applied to the emergency department with a preliminary diagnosis of pulmonary embolism. This study was conducted at Bursa Uludağ University Faculty of Medicine Hospital between January 2018 and December 2018. Patients aged 18 years and above whose D-dimer levels were checked considering the preliminary diagnosis of PE, were included in the study. A total of 3407 patients, 1961 male (57,6%) and 1446 female (42,4%), were included in the study. The mean age of the patients was calculated as 59,74 (+/-18,08). Upon investigation of 1968 patients with elevated D-dimer levels, PE was diagnosed in a total of 74 patients (10,54%) whereas the most common alternative diagnoses were 33,61% (n=236) pneumonia and 13,96% (n=98) Acute Coronary Syndrome, respectively. 315 (34,05%) out of 925 newly diagnosed patients were transfered to the Intensive Care Unit, 410 (44,32%) were hospitalized to the relevant clinics while 188 (20,32%) patients were discharged. On examination of 1443 patients with negative D dimer levels, pulmonary embolism was diagnosed in 7 (3,13%) patients whereas the most common other diagnoses were 44,84% (n=100) Acute Coronary Syndrome and 24,21% (n=54) pneumonia, respectively. 95 (42,6%) of these patients were admitted to the Intensive Care Unit, 70 (31,4%) were hospitalized and 54 (24,2%) patients were discharged. Pulmonary embolism was not the most common diagnosis in either group. However, in the D-dimer positive patient group, the rate of newly diagnosed patients requiring clinical and intensive care hospitalization was found to be significantly higher. In conclusion, even if pulmonary embolism is not detected in D-dimer positive cases, it is thought that these patients need further investigation and treatment, considering the frequency of serious conditions requiring clinical and intensive care unit admission.