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Massive Pulmonary Embolism With Negative D-dimer: A Case Report.
Cureus
December 2024
Nursing & Midwifery Research, Hamad Medical Corporation, Doha, QAT.
Pulmonary embolism (PE) is a critical condition that arises when clots migrate to the lungs, obstructing pulmonary circulation and posing a significant risk to the patient's health. While the D-dimer test is useful for excluding PE, it is not infallible. This report describes a case where extensive PE was present despite the patient having a normal D-dimer level, emphasizing the importance of a thorough clinical evaluation.
View Article and Find Full Text PDFDecision rules in the diagnostic work-up of aortic dissection.
Emerg Med J
January 2025
Department of Emergency Medicine, York Hospital, York, UK.
A short cut review of the literature was carried out to examine whether a decision rule in conjunction with a D-dimer can be used to rule out aortic dissection. 117 unique papers were found of which three systematic reviews included data on patients relevant to the clinical question; these are discussed in the paper. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated.
View Article and Find Full Text PDFDevelopment and internal validation of a simple clinical score for the estimation of the probability of deep vein thrombosis in outpatient emergency department patients.
Res Pract Thromb Haemost
November 2024
Internal Medicine Clinic, Østfold Hospital Trust, Sarpsborg, Norway.
Background: Wells score comprises subjective elements, making physicians reluctant to use Wells score or cause them to use it incorrectly.
Objectives: To develop and internally validate a prediction score that is objective and simple for evaluating suspected deep vein thrombosis (DVT), with a safety comparable with that of Wells score.
Methods: We performed a post hoc analysis using data from the Ri-Schedule study (NCT02486445) involving suspected DVT patients at Østfold Hospital's Emergency Department, Norway (2015-2018).
Diagnostic Test Accuracy of the YEARS Algorithm for Pulmonary Embolism: A systematic review and meta-analysis.
Sultan Qaboos Univ Med J
November 2024
Centre for Health and Social Care Research, School of Education, Midwifery and Social Work, Kingston University, Kingston upon Thames, United Kingdom.
This systematic review and meta-analysis aimed to assess the diagnostic accuracy of the YEARS algorithm in excluding pulmonary embolism, as well as to compare the utilisation of advanced imaging modalities between the YEARS approach and standard clinical practice. Eligible studies were identified from multiple databases spanning July 2017 to September 2022, following the Joanna Briggs Institute methodology for diagnostic accuracy reviews. A total of 10 studies, involving approximately 14,000 participants, were included in the analysis.
View Article and Find Full Text PDFBackground: This study aimed to assess the diagnostic value and safety of using Pulmonary Embolism Rule-Out Criteria (PERC) in an emergency care setting.
Methods: We conducted a retrospective application of the PERC to the patients suspected of having pulmonary embolism (PE) and who underwent computed tomography pulmonary angiogram (CTPA) Karolinska University Hospital's emergency department (ED) from 2016 to 2017. The patient data, including D-dimer (DD) and ED waiting times were extracted from the Karolinska Venous Thromboembolism cohort (VTE cohort).
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