What is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?

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dc.authoridBozkurt, Bulent/0000-0003-4764-3735;
dc.contributor.authorAtes, Hale
dc.contributor.authorAtes, Ihsan
dc.contributor.authorBozkurt, Bulent
dc.contributor.authorCelik, Huseyin Tugrul
dc.contributor.authorOzol, Duygu
dc.contributor.authorYildirim, Zeki
dc.date.accessioned2025-10-24T18:09:18Z
dc.date.available2025-10-24T18:09:18Z
dc.date.issued2016
dc.departmentMalatya Turgut Özal Üniversitesi
dc.description.abstractBecause of similar clinical manifestations and laboratory findings, differential diagnosis of pulmonary embolism and community-acquired pneumonia (CAP) is generally difficult. Therefore, this study was conducted to find good markers for the easy, cheap, and fast differential diagnosis of pulmonary embolism and CAP. Thirty-four patients diagnosed with pulmonary embolism and 38 patients with CAP who were admitted to either emergency department or chest diseases outpatient clinic were included in this study. On admission and third day, complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate, procalcitonin (PCT), and D-dimer levels of each patient were measured. Neutrophil-to-lymphocyte ratio (NLR) was calculated using the formula NLR = neutrophil count/lymphocyte count. NLR/D-dimer and PCT/D-dimer ratios were also calculated. First day neutrophil count (P = 0.005), NLR (P = 0.002), CRP (P < 0.001), erythrocyte sedimentation rate (P < 0.001), PCT (P < 0.001), NLR/D-dimer (P < 0.001), and PCT/D-dimer (P < 0.001) levels were higher in patients with CAP compared with patients with pulmonary embolism. In stepwise logistic regression analysis done with all the parameters used for the differential diagnosis of pulmonary embolism and CAP, CRP, PCT/D-dimer, and NLR/D-dimer were found to be independent predictive factors for the presence of CAP. Among these factors, NLR/D-dimer ratio was found to be the most sensitive (97.4%) to have the highest negative predictive value 96.7% and to be the most accurate (area under curve = 0.921) (91.7%) parameter for the differential diagnosis of pulmonary embolism and CAP. In this study, NLR/D-dimer ratio was found to be more sensitive and more selective with negative predictive value and area under curve for the differential diagnosis of pulmonary embolism and CAP compared with other laboratory tests.
dc.identifier.doi10.1097/MBC.0000000000000391
dc.identifier.endpage258
dc.identifier.issn0957-5235
dc.identifier.issn1473-5733
dc.identifier.issue3
dc.identifier.pmid26258679
dc.identifier.scopus2-s2.0-84962706013
dc.identifier.scopusqualityQ3
dc.identifier.startpage252
dc.identifier.urihttps://doi.org/10.1097/MBC.0000000000000391
dc.identifier.urihttps://hdl.handle.net/20.500.12899/3575
dc.identifier.volume27
dc.identifier.wosWOS:000373209400004
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofBlood Coagulation & Fibrinolysis
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_20251023
dc.subjectthrombus; thromboembolism; fever; infection; systemic inflammatory markers
dc.titleWhat is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?
dc.typeArticle

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