Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

ÖZSARAÇ, Murat; YÜRÜKTÜMEN, Aslıhan; Kiyan, Selahattin; AKSAY, Ersin; BAYRAKTAROĞLU, Selen; Çalkavur, İsmet Tanzer; Ersel, Murat

Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

Murat ERSEL, (Ege Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Ersin AKSAY, (Ege Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

GÜÇLÜ SELAHATTİN KIYAN, (Ege Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Selen BAYRAKTAROĞLU, (Ege Üniversitesi, Tıp Fakültesi, Radyodiagnostik Anabilim Dalı, İzmir, Türkiye)

Aslıhan YÜRÜKTÜMEN, (Ege Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Murat ÖZSARAÇ, (Ege Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Tanzer ÇALKAVUR (Ege Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir, Türkiye)

Anadolu Kardiyoloji Dergisi

3 1

Yıl: 2010 Cilt: 10 Sayı: 5 Sayfa Aralığı: 434 - 439 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

Öz:

Amaç: D-dimer testinin akut aort disseksiyonunu belirlemede tanısal değerini saptamak. Yöntemler: Bu çalışma retrospektif bir çalışmadır. Acil serviste akut aort disseksiyonu şüphesi mevcut olan ve ileri tetkik öncesi D-dimer testi istenen hastalar çalışmaya dâhil edilmiştir. 3. basamak bir sağlık kuruluşunda gerçekleştirilen çalışmada, Şubat 2006-Ağustos 2008 tarihleri arasındaki kayıtlar incelenmiştir. Kullanılan D-dimer ölçüm yöntemi immunoturbidimetrik yöntemdir ve 0.246 µg/ml'ye kadar olan sonuçlar normal olarak kabul edilmiştir. İstatistiksel analizde Ki-kare testi, Student’s t-testi kullanılmış, ayrıca ROC eğrisi analizi yapılmıştır. Bulgular: Çalışmaya 30 akut aort disseksiyonu mevcut, 69 akut aort disseksiyonu mevcut olmayan kontrol grubu olmak üzere 99 hasta dâhil edilmiştir. Bu iki gruba ait D-dimer ölçümlerinin karşılaştırılmasında akut aort disseksiyonu olan hastaların olmayanlara göre istatistiksel anlamlı olarak daha fazla pozitif sonucunun olduğu görülmüştür (p<0.001). Akut aort disseksiyonunu saptamada D-dimer testinin duyarlılığı %96.6 özgünlüğü %52.2 negatif prediktif değeri %97.3 pozitif prediktif değeri ise %46.8 olarak bulunmuştur. ROC analizi sonucunda eğri altında kalan (AUC) değeri 0.764 (CI %95: 0.674-0.855) ve p<0.001) olarak saptanmıştır. Sonuç: D-dimer testinin acil serviste akut aort disseksiyonu şüphesi olan hastalarda akut disseksiyonun saptanması için kullanımı faydalıdır.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

D-dimer testi akut aort disseksiyonlarını belirlemede acil servis hekimlerine yardımcı olabilir mi?

Öz:

Objective: To determine the diagnostic accuracy of D-dimer testing for detection of acute aortic dissection. Methods: This study is a retrospective chart review of patients who had been evaluated with suspicion of acute aortic dissection. All patients’ D-dimer levels were determined prior to their further work up in the emergency department. The study was conducted in a tertiary care center between February 2006-August 2008. The D-dimer assay used was the immunoturbidimetric assay, with a normal range up to 0.246 µg/ml. Statistical analysis was accomplished using Chi-square test, Student’s t-test and a receiver-operating characteristics (ROC) curve analysis.Results: Ninety-nine patients were included in the study, 30 patients were diagnosed as having acute aortic dissection and 69 patients were evaluated in non-acute aortic dissection group. In comparison of the two groups, positive D-dimer results were found to be significantly higher in acute aortic dissection group than in non-acute aortic dissection group (p<0.001). Sensitivity of the D-dimer test in detection of acute aortic dissection was found as 96.6% and the negative predictive value of the test was 97.3%. Specificity and positive predictive value of the D-dimer test were 52.2% and 46.8%, respectively. The area under the ROC curve yielded an acceptable certainty for excluding acute aortic dissection on base of negative results (AUC: 0.764; CI 95%: 0.674-0.855; p<0.001). Conclusion: D-dimer testing is helpful for emergency physicians in detection of patients with suspected acute aortic dissection in the emergency department.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Ersel M, AKSAY E, Kiyan S, BAYRAKTAROĞLU S, YÜRÜKTÜMEN A, ÖZSARAÇ M, Çalkavur İ (2010). Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. , 434 - 439.
Chicago	Ersel Murat,AKSAY Ersin,Kiyan Selahattin,BAYRAKTAROĞLU Selen,YÜRÜKTÜMEN Aslıhan,ÖZSARAÇ Murat,Çalkavur İsmet Tanzer Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. (2010): 434 - 439.
MLA	Ersel Murat,AKSAY Ersin,Kiyan Selahattin,BAYRAKTAROĞLU Selen,YÜRÜKTÜMEN Aslıhan,ÖZSARAÇ Murat,Çalkavur İsmet Tanzer Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. , 2010, ss.434 - 439.
AMA	Ersel M,AKSAY E,Kiyan S,BAYRAKTAROĞLU S,YÜRÜKTÜMEN A,ÖZSARAÇ M,Çalkavur İ Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. . 2010; 434 - 439.
Vancouver	Ersel M,AKSAY E,Kiyan S,BAYRAKTAROĞLU S,YÜRÜKTÜMEN A,ÖZSARAÇ M,Çalkavur İ Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. . 2010; 434 - 439.
IEEE	Ersel M,AKSAY E,Kiyan S,BAYRAKTAROĞLU S,YÜRÜKTÜMEN A,ÖZSARAÇ M,Çalkavur İ "Can D-dimer testing help emergency department physicians to detect acute aortic dissections?." , ss.434 - 439, 2010.
ISNAD	Ersel, Murat vd. "Can D-dimer testing help emergency department physicians to detect acute aortic dissections?". (2010), 434-439.

APA	Ersel M, AKSAY E, Kiyan S, BAYRAKTAROĞLU S, YÜRÜKTÜMEN A, ÖZSARAÇ M, Çalkavur İ (2010). Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. Anadolu Kardiyoloji Dergisi, 10(5), 434 - 439.
Chicago	Ersel Murat,AKSAY Ersin,Kiyan Selahattin,BAYRAKTAROĞLU Selen,YÜRÜKTÜMEN Aslıhan,ÖZSARAÇ Murat,Çalkavur İsmet Tanzer Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. Anadolu Kardiyoloji Dergisi 10, no.5 (2010): 434 - 439.
MLA	Ersel Murat,AKSAY Ersin,Kiyan Selahattin,BAYRAKTAROĞLU Selen,YÜRÜKTÜMEN Aslıhan,ÖZSARAÇ Murat,Çalkavur İsmet Tanzer Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. Anadolu Kardiyoloji Dergisi, vol.10, no.5, 2010, ss.434 - 439.
AMA	Ersel M,AKSAY E,Kiyan S,BAYRAKTAROĞLU S,YÜRÜKTÜMEN A,ÖZSARAÇ M,Çalkavur İ Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. Anadolu Kardiyoloji Dergisi. 2010; 10(5): 434 - 439.
Vancouver	Ersel M,AKSAY E,Kiyan S,BAYRAKTAROĞLU S,YÜRÜKTÜMEN A,ÖZSARAÇ M,Çalkavur İ Can D-dimer testing help emergency department physicians to detect acute aortic dissections?. Anadolu Kardiyoloji Dergisi. 2010; 10(5): 434 - 439.
IEEE	Ersel M,AKSAY E,Kiyan S,BAYRAKTAROĞLU S,YÜRÜKTÜMEN A,ÖZSARAÇ M,Çalkavur İ "Can D-dimer testing help emergency department physicians to detect acute aortic dissections?." Anadolu Kardiyoloji Dergisi, 10, ss.434 - 439, 2010.
ISNAD	Ersel, Murat vd. "Can D-dimer testing help emergency department physicians to detect acute aortic dissections?". Anadolu Kardiyoloji Dergisi 10/5 (2010), 434-439.