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Pulmonary embolism diagnosis with D-dimer levels and computed tomography
Rochelle A Kruger1, Jeanetta du Plessis1, Henra Muller1
1Department of Clinical Sciences, Faculty of Health and Environmental Sciences, Central University of Technology, Bloemfontein, South Africa.
Health SA = SA Gesondheid
|July 11, 2025
Summary
Elevated D-dimer levels did not strongly correlate with positive pulmonary embolism (PE) diagnoses via CTPA in this study. Refining clinical decision rules is recommended to reduce unnecessary CTPA referrals for suspected PE.
Area of Science:
- Cardiology
- Radiology
- Diagnostic Imaging
Background:
- Pulmonary embolism (PE) is a critical cardiovascular condition with significant mortality risks.
- Prompt diagnosis and treatment are essential for managing PE.
- Diagnostic challenges exist, particularly in differentiating PE from other causes of chest pain.
Purpose of the Study:
- To investigate the association between elevated D-dimer levels and confirmed pulmonary embolism (PE) diagnoses using computed tomography pulmonary angiography (CTPA).
- To evaluate the diagnostic utility of D-dimer testing in patients with suspected PE.
Main Methods:
- Retrospective data collection from a private diagnostic radiology practice.
- Analysis of patient data including D-dimer levels and CTPA results.
- Statistical analysis using Chi-square test to determine the relationship between D-dimer and PE diagnosis.
Main Results:
- Only 16.7% of 1219 patients were diagnosed with PE via CTPA.
- No significant correlation was found between elevated D-dimer levels and a positive PE diagnosis (p=0.175).
- A high percentage (86%) of patients with elevated D-dimer did not have PE.
Conclusions:
- The study found no strong relationship between elevated D-dimer and CTPA-confirmed PE.
- Current clinical decision rules for PE workup may require refinement.
- Recommendations include revising PE workup protocols to minimize unnecessary CTPA referrals and improve service quality.
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