DIAGNOSTIC ACCURACY OF D-DIMER FOR PULMONARY EMBOLISM: DETERMINATION OF AN OPTIMAL HIGH CUTOFF VALUE

Abstract: It might be difficult to diagnose acute pulmonary embolism (APE) in a timely manner since it is a potentially lethal illness. The preferred modality is now computed tomography pulmonary angiography (CTPA), which adds to the growing strain on CT scanners in emergency rooms.Objective: To evaluate the diagnostic role of D-dimer and determine an optimal cut-off value for predicting PE and retain a high sensitivity and negative predictive value (NPV) while lowering the need for CTPA.Methods: A retrospective analysis was conducted on 70 patients. Demographic data, D-dimer levels, and PE status were analyzed. ROC curve analysis was used to determine the optimal cut-off value, and sensitivity, specificity, PPV, and NPV were calculated. The results showed that the mean age was 57.8 ± 18.86 years, with 71.4% females. PE was present in 31.4% of patients. The optimal D-dimer cut-off value was 3500 ng/ml, yielding a sensitivity of 90.9%, specificity of 95.8%, PPV of 90.9%, and NPV of 95.8%. Higher D-dimer levels were associated with proximal PE. It is concluded that D-dimer demonstrated excellent diagnostic accuracy for PE. A higher cut-off value improved specificity while maintaining high sensitivity, supporting its clinical utility in both ruling in and ruling out PE