Key result
Very high D-dimer fails to predict in-hospital mortality in hemodynamically stable PE.
Why the study?
Prognosis of pulmonary embolism based on D-dimer levels has shown mixed results, and data on in-hospital prognosis of stable patients are sparse.
Does a D-dimer level ≥5000 ng/mL predict higher in-hospital mortality in stable patients with pulmonary embolism?
Cohort (n=292)
Does a D-dimer level ≥5000 ng/mL predict higher in-hospital mortality in stable patients with pulmonary embolism?
Absolute Event Rate: 2.9% vs 0%
p-value: p=.06
Markedly elevated D-dimer levels (≥5000 ng/mL) do not significantly predict higher in-hospital PE-related or all-cause mortality in stable patients with pulmonary embolism.
D-dimer ≥5000 ng/mL does not identify higher in-hospital mortality risk in stable PE; hypothesis-generating and should not yet change practice.
Prognosis of pulmonary embolism (PE) based on levels of D-dimer has shown mixed results, and data on in-hospital prognosis of stable patients are sparse. We assessed in-hospital prognosis in 292 stable patients with PE based on retrospective chart review using an arbitrarily selected value of D-dimer ≥5000 ng/mL as cut-off level. In-hospital mortality from PE was 0% (0 of 222) with D-dimer <5000 ng/mL compared with 2.9% (2 of 70) with D-dimer ≥5000 ng/mL (P = .06). In-hospital all-cause mortality was 2.3% (5 of 222) with D-dimer <5000 ng/mL compared with 2.9% (2 of 70) with D-dimer ≥5000 ng/mL (NS). Markedly elevated levels of D-dimer, therefore, did not indicate a high mortality from PE or all-cause mortality during hospitalization.
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Stein et al. (2011) conducted a cohort in Pulmonary embolism (n=292). D-dimer ≥5000 ng/mL vs. D-dimer <5000 ng/mL was evaluated on In-hospital mortality from PE (p=.06). D-dimer ≥5000 ng/mL did not significantly increase in-hospital mortality from PE (2.9% vs 0%, P=0.06) or all-cause mortality (2.9% vs 2.3%, NS) compared to <5000 ng/mL in stable PE patients.
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