The DiPEP study: an observational study of the diagnostic accuracy of clinical assessment, D-dimer and chest x-ray for suspected pulmonary embolism in pregnancy and postpartum

BJOG : an International Journal of Obstetrics and Gynaecology
S GoodacreDiPEP research group

Abstract

To identify clinical features associated with pulmonary embolism (PE) diagnosis and determine the accuracy of decision rules and D-dimer for diagnosing suspected PE in pregnant/postpartum women DESIGN: Observational cohort study augmented with additional cases. Emergency departments and maternity units at eleven prospectively recruiting sites and maternity units in the United Kingdom Obstetric Surveillance System (UKOSS) POPULATION: 324 pregnant/postpartum women with suspected PE and 198 pregnant/postpartum women with diagnosed PE METHODS: We recorded clinical features, elements of clinical decision rules, D-dimer measurements, imaging results, treatments and adverse outcomes up to 30 days MAIN OUTCOME MEASURES: Women were classified as having PE on the basis of imaging, treatment and adverse outcomes by assessors blind to clinical features and D-dimer. Primary analysis was limited to women with conclusive imaging to avoid work-up bias. Secondary analyses included women with clinically diagnosed or ruled out PE. The only clinical features associated with PE on multivariate analysis were age (odds ratio 1.06; 95% confidence interval 1.01-1.11), previous thrombosis (3.07; 1.05-8.99), family history of thrombosis (0.35; 0.14-0.90)...Continue Reading

References

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Citations

May 5, 2020·Circulation·Laxmi S MehtaUNKNOWN American Heart Association Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Cou
May 20, 2020·Therapeutic Advances in Respiratory Disease·Hanke M G Wiegers, Saskia Middeldorp
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Mar 21, 2020·Breathe·Aleksandar BokanJadranka Vucicevic Trobok
Jul 16, 2019·Annals of Internal Medicine·Steve GoodacreCatherine Nelson-Piercy
May 28, 2020·Internal and Emergency Medicine·Stavros Konstantinides, Guy Meyer
Mar 21, 2019·The New England Journal of Medicine·Liselotte M van der PolUNKNOWN Artemis Study Investigators
Jun 20, 2019·The New England Journal of Medicine·Liselotte M van der PolUNKNOWN Artemis Study Investigators
Apr 28, 2021·PLoS Medicine·Lauren J GreenUNKNOWN International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st)
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Dec 7, 2021·Revista brasileira de ginecologia e obstetrícia : revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia·Clara Nunes CastroJussara Mayrink

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Software Mentioned

UKOSS

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