Relationship Between CRP, D-Dimer, D-Dimer/CRP with Clinical Probability and Diagnostic Value in Patients with Suspected Pulmonary Thoromboembolism

Objective: It was planned to investigate the diagnostic values for pulmonary thromboembolisym (PTE) by examining D-dimer, C-Reactive Protein (CRP), D-dimer/CRP ratio of patients who underwent computed tomography pulmonary angiography (CTPA) and/or lung scintigraphy with pre-diagnosis of pulmonary embolism. So it was thought that unnecessary computed tomograpy pulmonary Angiography could be reduced. Method: In our study, patients who were admitted to the chest diseases outpatient clinic and emergency department, who underwent CT pumonary Angiography and/or lung scintigraphy with a pre-diagnosis of pulmonary embolism, and who were simultaneously studied for D-dimer and CRP examinations were retrospectively evaluated. The efficiency and reliability of the Wells score and the combination of D-dimer, CRP and D-dimer/CRP ratio in the prediagnosis of pulmonary embolism were evaluated. Results: 46 of 79 patients with suspected pulmonary embolism included in our study were diagnosed with pulmonary thromboembolism with advanced tests. While the sensitivity and specificity of Wells score, D-dimer and CRP in diagnosing PTE were 41.3-100%, 91.3-27.3% and 84.7-42.4%, respectively, the cut off value of D-dimer/CRP ratio was 119.5. We found statistically significant higher D-dimer levels in patients with probable PTE according to Wells clinical scores. However, D-dimer/CRP ratio and CRP levels were statistically insignificant. Conclusion: In our study, D-dimer and CRP ratios were found to be significantly higher in patients with PTE, but D-dimer/CRP ratios were found to be less valuable in the diagnosis of PTE sensitivity and specificity.