open access

Vol 80, No 2 (2012)
ORIGINAL PAPERS
Published online: 2012-02-27
Submitted: 2013-02-22
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Normal D-dimer concentration in hospitalized patients with lung diseases

Anna Fijałkowska, Elżbieta Wiatr, Marcin Kurzyna, Paweł Kuca, Janusz Burakowski, Jarosław Kober, Monika Szturmowicz, Liliana Wawrzyńska, Barbara Roszkowska-Śliż, Witold Tomkowski, Kazimierz Roszkowski-Śliż, Adam Torbicki
Pneumonol Alergol Pol 2012;80(2):101-108.

open access

Vol 80, No 2 (2012)
ORIGINAL PAPERS
Published online: 2012-02-27
Submitted: 2013-02-22

Abstract

Introduction: The use of D-dimer testing is an established part of the diagnosis of suspected pulmonary embolism (PE). However, in hospitalized patients many various factors might be responsible for increased D-dimer concentration and they could lower utility of D-dimer in exclusion of PE in such population. According to some published data, calculating the index D-dimer/fibrinogen could increase the specificity of D-dimer in the recognition of venous thromboembolism (VTE). The aim of the present study was to determine the frequency of normal D-dimer concentration in hospitalized patients with lung diseases in whom the differential diagnosis of PE is particularly difficult and to evaluate the utility of the index D-dimer/fibrinogen in subgroups of patients: with acute VTE and with lung cancer.
Material and methods: 619 consecutive patients aged 54.9 (± 15.4) hospitalized in reference pulmonary center were enrolled into observation. Among them, there were 96 (15%) patients with acute VTE, 65 (10%) with exacerbation of COPD and 172 (27%) with lung cancer.
Results: Mean D-dimer concentration (Vidas D-dimer New) was 1956 ± 3691 ng/ml and median value 842 (45–35 678) ng/ml. Normal D-dimer concentration (< 500 ng/ml) was found in 225/523 (43%) without acute VTE. In 49% (32/65) patients with COPD and in 25% (43/172) patients with lung cancer D-dimer concentration was below 500 ng/ml as well. The index D-dimer/fibrinogen was significantly higher in acute VTE patients compared to lung cancer patients — 808 ± 688 and 289 ± 260 respectively, p < 0.001.
Conclusions: Normal D-dimer concentration was found in more than 40% of patients with lung diseases hospitalized in reference pulmonary center. This observation could suggest higher than described in the literature utility of D-dimer measurement in exclusion of PE in such a population. The value of the index D-dimer/fibrinogen, which is significantly higher in acute VTE than in lung cancer requires further evaluation to establish its clinical utility.

Abstract

Introduction: The use of D-dimer testing is an established part of the diagnosis of suspected pulmonary embolism (PE). However, in hospitalized patients many various factors might be responsible for increased D-dimer concentration and they could lower utility of D-dimer in exclusion of PE in such population. According to some published data, calculating the index D-dimer/fibrinogen could increase the specificity of D-dimer in the recognition of venous thromboembolism (VTE). The aim of the present study was to determine the frequency of normal D-dimer concentration in hospitalized patients with lung diseases in whom the differential diagnosis of PE is particularly difficult and to evaluate the utility of the index D-dimer/fibrinogen in subgroups of patients: with acute VTE and with lung cancer.
Material and methods: 619 consecutive patients aged 54.9 (± 15.4) hospitalized in reference pulmonary center were enrolled into observation. Among them, there were 96 (15%) patients with acute VTE, 65 (10%) with exacerbation of COPD and 172 (27%) with lung cancer.
Results: Mean D-dimer concentration (Vidas D-dimer New) was 1956 ± 3691 ng/ml and median value 842 (45–35 678) ng/ml. Normal D-dimer concentration (< 500 ng/ml) was found in 225/523 (43%) without acute VTE. In 49% (32/65) patients with COPD and in 25% (43/172) patients with lung cancer D-dimer concentration was below 500 ng/ml as well. The index D-dimer/fibrinogen was significantly higher in acute VTE patients compared to lung cancer patients — 808 ± 688 and 289 ± 260 respectively, p < 0.001.
Conclusions: Normal D-dimer concentration was found in more than 40% of patients with lung diseases hospitalized in reference pulmonary center. This observation could suggest higher than described in the literature utility of D-dimer measurement in exclusion of PE in such a population. The value of the index D-dimer/fibrinogen, which is significantly higher in acute VTE than in lung cancer requires further evaluation to establish its clinical utility.
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Keywords

D-dimer; lung diseases; lung cancer; hospitalized patients

About this article
Title

Normal D-dimer concentration in hospitalized patients with lung diseases

Journal

Advances in Respiratory Medicine

Issue

Vol 80, No 2 (2012)

Pages

101-108

Published online

2012-02-27

Bibliographic record

Pneumonol Alergol Pol 2012;80(2):101-108.

Keywords

D-dimer
lung diseases
lung cancer
hospitalized patients

Authors

Anna Fijałkowska
Elżbieta Wiatr
Marcin Kurzyna
Paweł Kuca
Janusz Burakowski
Jarosław Kober
Monika Szturmowicz
Liliana Wawrzyńska
Barbara Roszkowska-Śliż
Witold Tomkowski
Kazimierz Roszkowski-Śliż
Adam Torbicki

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