Exclusion of pulmonary embolism using C-reactive protein and D-dimer. A prospective comparison.

摘要: Our goal was to evaluate the diagnostic utility of C-reactive protein (CRP) alone or combined with clinical probability assessment in patients suspected pulmonary embolism (PE), and compare its performance a D-dimer assay. We conducted prospective study which we performed com-mon immuno-turbidimetric CRP test rapid enzyme-linked immunosorbent assay (ELISA) 259 consecutive outpatients PE at emergency department teaching hospital. assessed by validated prediction rule overridden judgment. Patients levels =500 µg/l underwent work-up consisting lower-limb venous ultrasound, spiral computer-ized tomography, ventilation-perfusion scan, angiography. were followed up for three months. Seventy-seven (30%) had PE.The sensitivity 84% (95% confidence interval [CI).: 74 92%) negative predictive value (NPV) 87% CI: 78 93%) cutpoint 5 mg/l. Overall, 61 (24%) low < Due prevalence (9%) this subgroup, NPV increased 97% 89 100%).The (cutpoint 500 µg/l) showed 100% 95 100%) 94 irrespective probabil-ity accurately out 56 (22%) patients. Standard tests assess-ment cannot safely exclude PE.