Diagnostic values of laboratory and imaging methods for the patients with pulmonary embolism in the emergency service

DIAGNOSTIC VALUES OF LABORATORY AND IMAGING METHODS FOR THE PATIENTS WITH PULMONARY EMBOLISM IN THE EMERGENCY SERVICE Introduction: Mortality rate of pulmonary embolism is high, and one of the factors which have effect upon mortality is the location of Pulmonary Embolism. In this study, we have intended to analyse the efficiencies of anamnesis, laboratory and imaging methods in determining whether Pulmonary Embolism is peripheral or central in the diagnose process in emergency service. Material And Method: The study has been implemented between 01.01.2015 and 31.12.2016 through comparing two groups of patients, who received the diagnose of Pulmonary Embolism, in terms of anamnesis, laboratory and imaging methods after they have been dived into central and peripheral branch involvement. Results: The median for totally 103 patients who have been included in the study was 62,5 (min: 44-max: 77), and 64 % of them were female. It is detected that most frequent complaint was laboured breathing (59,2 %) and most frequently encountered risk factor was operation history (12,6 %). While no significant difference is detected between the groups in terms of D-dimer, PH, PCO2, PO2, haemoglobin, RDW, PLR, NLR, urea, creatinine, potassium, INR, CRP values (p>0.05) and calculated Wells scores; it is been detected that lactate (p=0,003), hs-Troponin (p=0,003), sodium (p=0,036) and chlorine (p=0,018) values are significantly high in the group which has central branch involvement (p>0,05). It is found, through ROC analysis, that optimal lactate cutoff-sector-truncation value was 2,45 and optimal chlorine cutoff -sector-truncation value was 106,5 for the group which has central branch involvement (sensitivities were 60 %, 16 % and specificities were 75 %, 95 % respectively). As for short period mortality, it is determined that mortality is high for central branch involvement, yet this state is statistically insignificant (p>0,05). Conclusion: In diagnostic approach of Pulmonary Embolism, central branch involvement should come to mind for the case where sodium, chorine, hs-Troponin and lactate values are determined at high level. However, additional studies which will bolster this outcome are needed. Key Words: Emergency, Pulmonary Embolism, Diagnostic, Peripheral, Central.