Beyond the fractures: A comprehensive Comparative analysis of Affordable and Accessible laboratory parameters and their coefficients for prediction and Swift confirmation of pulmonary embolism in high-risk orthopedic patients

IF 1.7 Q3 MEDICAL LABORATORY TECHNOLOGY

Practical Laboratory Medicine Pub Date : 2024-05-01 DOI:10.1016/j.plabm.2024.e00397

Piotr Piech , Mateusz Haratym , Bartosz Borowski , Robert Węgłowski , Grzegorz Staśkiewicz

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引用次数: 0

Abstract

Background

Pulmonary embolism (PE) poses a significant challenge in diagnosis and treatment, particularly in high-risk patient populations such as those hospitalized for orthopedic reasons. This study explores the predictive and diagnostic potential of laboratory parameters in identifying PE among orthopedic patients.

Objectives

The purpose of this study was to determine whether selected (inexpensive and readily available) laboratory parameters and their coefficients can be used to diagnose pulmonary embolism and whether they are applicable in predicting its occurrence.

Material and methods

Selected laboratory parameters were determined twice in 276 hospitalized orthopedic patients with suspected PE: PLT, MPV, NEU, LYM, D-dimer, troponin I, age-adjusted D-dimer and their coefficients. Depending on the angio-CT results, patients were divided into groups. Selected popular laboratory coefficients were calculated and statistically analyzed. Optimal cutoff points were determined for the above laboratory tests and ROC curves were plotted.

Results

D-dimer/troponin I [p = 0.008], D-dimer [p = 0.001], age-adjusted D-dimer [p = 0.007], NLR/D-dimer [p = 0.005] and PLR [p = 0.021] are statistically significant predictors of PE. D-dimer/troponin I [p < 0.001], troponin I [p = 0.005] and age-adjusted D-dimer [p = 0.001] correlated with the diagnosis of PE after the onset of clinical symptoms.

Conclusions

In the context of orthopedic patients, cost-effective laboratory parameters, particularly the D-dimer/troponin I ratio and age-adjusted D-dimer, exhibit considerable potential in predicting and diagnosing PE. These findings suggest that combining readily available laboratory tests with clinical observation can offer a viable and cost-effective diagnostic alternative, especially in resource-constrained settings. Further studies with larger and diverse patient populations are recommended to validate these results.

查看原文本刊更多论文

骨折之外：全面比较分析高风险骨科患者肺栓塞的可负担和可获得的实验室参数及其预测和 Swift 确认系数

背景肺栓塞（PE）给诊断和治疗带来了巨大挑战，尤其是在高危患者人群中，如因骨科原因住院的患者。本研究探讨了实验室参数在识别骨科患者肺栓塞方面的预测和诊断潜力。目的本研究的目的是确定选定的（廉价且容易获得的）实验室参数及其系数是否可用于诊断肺栓塞，以及是否可用于预测肺栓塞的发生。材料和方法对 276 名疑似肺栓塞的住院骨科患者进行了两次选定实验室参数的测定：PLT、MPV、NEU、LYM、D-二聚体、肌钙蛋白 I、年龄调整后的 D-二聚体及其系数。根据血管造影 CT 的结果，将患者分为不同的组别。对选定的常用实验室系数进行计算和统计分析。结果 D-二聚体/肌钙蛋白 I [p = 0.008]、D-二聚体[p = 0.001]、年龄调整后的 D-二聚体[p = 0.007]、NLR/D-二聚体[p = 0.005]和 PLR [p = 0.021]是预测 PE 的有统计学意义的指标。结论在骨科患者中，具有成本效益的实验室参数，尤其是 D-二聚体/肌钙蛋白 I 比值和年龄调整后的 D-二聚体，在预测和诊断 PE 方面具有相当大的潜力。这些研究结果表明，将现成的实验室检测与临床观察相结合，可提供一种可行且具有成本效益的诊断替代方法，尤其是在资源有限的情况下。为了验证这些结果，建议对更多不同的患者群体进行进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Practical Laboratory Medicine Health Professions-Radiological and Ultrasound Technology

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

7 weeks

期刊介绍： Practical Laboratory Medicine is a high-quality, peer-reviewed, international open-access journal publishing original research, new methods and critical evaluations, case reports and short papers in the fields of clinical chemistry and laboratory medicine. The objective of the journal is to provide practical information of immediate relevance to workers in clinical laboratories. The primary scope of the journal covers clinical chemistry, hematology, molecular biology and genetics relevant to laboratory medicine, microbiology, immunology, therapeutic drug monitoring and toxicology, laboratory management and informatics. We welcome papers which describe critical evaluations of biomarkers and their role in the diagnosis and treatment of clinically significant disease, validation of commercial and in-house IVD methods, method comparisons, interference reports, the development of new reagents and reference materials, reference range studies and regulatory compliance reports. Manuscripts describing the development of new methods applicable to laboratory medicine (including point-of-care testing) are particularly encouraged, even if preliminary or small scale.