Determination of Diagnostic Value of Albumin, Anti Thrombin Ш, and Fibrinogen Factors in the Diagnosis of Pulmonary Embolism Compared to Lung Perfusion Scan in Patients with Nephrotic Syndrome

Bachground: The aim of this study was to determine of diagnostic value of albumin, anti-thrombin Ш, and fibrinogen factors in the diagnosis of pulmonary embolism compared to lung perfusion scan in patients with nephrotic syndrome referred to Hazrat Ali Asghar hospital of Tehran city (Iran) in 2018-2019.  Methods: This study was cross sectional study that was carried out on 30 patients with nephrotic syndrome referred to Hazrat Ali Asghar hospital of Tehran city (Iran) in 2018-2019. Initially, lung perfusion scan as gold standard was performed for all patients, then, albumin, anti-thrombin Ш, and fibrinogen factors as screening tests were checked for these patients. After data collection, the data were entered into the STATA14 software, then, determined and compared the sensitivity, specificity, positive predictive value, predictive value and ROC curve level of these screening tests with the results of the lung perfusion. The significance level was considered < 0.05.  Results: The mean (SD) age of the patients under study was 6.22 (3.50), also 70% (21 cases) were boy and 30% (9) were girl. The results of lung perfusion scan showed that 23.3% (7 cases) of patients with nephrotic syndrome have pulmonary embolism. The results of analytical analyzes also showed that sensitivity, specificity, positive predictive value and negative predictive value for albumin were 100, 21.74, 28, 100% respectively, for anti-thrombin Ш were 100, 52.17, 38.88 and 100% , for fibrinogen were 100, 56.52, 41.17 and 100% respectively. Also, the area under the ROC curve for albumin, anti-thrombin Ш, and fibrinogen were 0.6087, 0.7609, and 0.7826, respectively. Conclusion: The present study showed that fibrinogen screening test had the highest diagnostic value in comparison with other screening tests of albumin and anti-thrombin Ш in detection of pulmonary embolism in patients with nephrotic syndrome. However, given the low sample size, more studies are recommended in this area.