Diagnostic value of plasma neutrophil gelatinase-associated lipocalin levels in pulmonary thromboembolism

DIAGNOSTİC VALUE OF PLASMA NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN LEVELS IN PULMONARY THROMBOEMBOLISM Summary Introduction and aim: Despite the developments in diagnostic methods, pulmonary tromboembolism is one of the disease that difficulties of early diagnose and initiation of treatments and high rates of mortality and morbidity due to delays are experienced. In our study, neutrophil gelatinase-associated lipocalin test as a biochemical marker thought to be high diagnostic value , fast , non invasive , inexpensive and easily accesible for aimed to determine the diagnostic value of thromboembolic disease. Materials and methods: Patients with pulmonary thromboembolism symptoms admitted to the emergency department of Dokuz Eylul University who had clinical, examinations findings which are suspected pulmonary thromboembolism and had no exclusion criteria, scanned with computed tomographic pulmonary angiography, provided written informed consent were included into this study. Patients with diagnoses that may cause the height of neutrophil gelatinase-associated lipocalin were excluded. Blood samples had been taken from the patient in bedside to study neutrophil gelatinase-associated lipocalin levels and other routin tests in biochemistry laboratory before administration of intravenous contrast substance for scaning of computed tomographic pulmonary angiography. In our study, diagnostic value of the neutrophil gelatinase-associated lipocalin test according to validity of computed tomographic pulmonary angiography was investigated. Results: 31 (44.9%) of the 69 patients who included to the study and neutrophil gelatinase-associated lipocalin levels detected and scanned with computed tomography pulmonary angiography patients were diagnosed as pulmonary embolism. 38 patients (55%), pulmonary thromboembolism had not been showed by computed tomographic pulmonary angiography. In compare the patients who have pulmonary thromboembolism and patients who have not pulmonary thromboembolism there were no significant difference according to the comorbid diseases, age, gender. Dispnea and chest pain in the patient admitted to the emergency department are seen the most frequent complaint. However there were no signifacantly difference in complaints of the patients between diagnosed pulmonary thromboembolism and not diagnosed pulmonary thromboembolism except for the syncope for incoming to the emergency services. Neutrophil gelatinase-associated lipocalin levels in patients with pulmonary thromboembolism were determined significantly higher. There were no signifacantly difference between the patients diagnosed pulmonary thromboembolism and not diagnosed pulmonary thromboembolism in biochemical values except for neutrophil gelatinase-associated lipocalin and blood urea nitrogen levels. Cutoff concentration of neutrophil gelatinase-associated lipocalin for the presence of pulmonary embolism was 88 ng/ml and based on most sensitivity and spesificity. The sensitivity and specificity of this cutoff concentration for the diagnose of pulmonary embolism were 70.97% and 60.53%, respectively, which give positive and negative predictive values of 59.46% and 71.88% Conclusion: Significantly high neutrophil gelatinase-associated lipocalin levels in patients were diagnosed as pulmonary embolism who into emegency department could not predict as reliable biochemical marker for diagnose of pulmonary embolism