Evidence map›Paper›PMID 33413585›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2021

Serum D-dimer level as a biomarker for identifying patients with isolated injury to prevent unnecessary whole-body computed tomography in blunt trauma care.

Rakuhei Nakama, Ryo Yamamoto, Yoshimitsu Izawa, Keiichi Tanimura, Takashi Mato

Open access · goldAbstract read
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Rakuhei NakamaDepartment of Emergency Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashi-machi, Utsunomiya, Tochigi, 321-0974, Japan. r.n.emergency0611@gmail.com.ORCID http://orcid.org/0000-0001-7877-5816
Ryo YamamotoDepartment of Emergency and Critical Care Medicine, Keio University school of medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
Yoshimitsu IzawaDepartment of Emergency and Critical Care Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Keiichi TanimuraDepartment of Radiology, Saiseikai Utsunomiya Hospital, 911-1 Takebayashi-machi, Utsunomiya, Tochigi, 321-0974, Japan.
Takashi MatoDepartment of Emergency and Critical Care Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Jichi Medical University · JPKeio University · JPSaiseikai Utsunomiya hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnnecessary whole-body computed tomography (CT) may lead to excess radiation exposure. Serum D-dimer levels have been reported to correlate with injury severity. We examined the predictive value of serum D-dimer level for identifying patients with isolated injury that can be diagnosed with selected-region CT rather than whole-body CT.

methodsThis single-center retrospective cohort study included patients with blunt trauma (2014-2017). We included patients whose serum D-dimer levels were measured before they underwent whole-body CT. "Isolated" injury was defined as injury with Abbreviated Injury Scale (AIS) score ≤ 5 to any of five regions of interest or with AIS score ≤ 1 to other regions, as revealed by a CT scan. A receiver operating characteristic curve (ROC) was drawn for D-dimer levels corresponding to isolated injury; the area under the ROC (AUROC) was evaluated. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for several candidate cut-off values for serum D-dimer levels.

resultsIsolated injury was detected in 212 patients. AUROC was 0.861 (95% confidence interval [CI]: 0.815-0.907) for isolated injury prediction. Serum D-dimer level ≤ 2.5 μg/mL was an optimal cutoff value for predicting isolated injury with high specificity (100.0%) and positive predictive value (100.0%). Approximately 30% of patients had serum D-dimer levels below this cutoff value.

conclusionD-dimer level ≤ 2.5 μg/mL had high specificity and high positive predictive value in cases of isolated injury, which could be diagnosed with selected-region CT, reducing exposure to radiation associated with whole-body CT.

Indexed as

Tomography, X-Ray ComputedUnnecessary ProceduresAdultBiomarkersFemaleFibrin Fibrinogen Degradation ProductsHumansMaleMiddle AgedRetrospective StudiesROC CurveWounds, NonpenetratingBiomarkersFibrin Fibrinogen Degradation Productsfibrin fragment DBlunt traumaComputed tomographyD-dimerMultiple traumaRadiation exposureWhole-body CT

Identifiers

PMID33413585
PMCPMC7789640
OpenAlexW3119441358

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.