Clinical usefulness and safety of an age-adjusted D-dimer cutoff levels to exclude pulmonary embolism: a retrospective analysis

Internal and Emergency Medicine
J FloresI Arribas

Abstract

Age-adjusted D-dimer (AADD) appears to increase the proportion of patients in whom pulmonary embolism (PE) can safely be excluded compared with conventional D-dimer (CDD), according to a limited number of studies. The aim if this study was to assess whether the use of an AADD might safely increase the clinical usefulness of CDD for the diagnosis of PE in our setting. Three hundred and sixty two consecutive outpatients with clinically suspected PE in whom plasma samples were obtained to measure D-dimer were included in this post hoc analysis of a previous study. CDD cutoff value was 500 ng/mL and AADD was calculated as (patient's age × 10) ng/mL in patients aged >50. Sensitivity, specificity, clinical usefulness (i.e., proportion of true-negative tests among all patients with suspected PE), and the proportion of false negatives were calculated for both AADD and CDD among patients with low-to-moderate clinical probability of PE according to Well's criteria. PE was confirmed in 98 patients (27%). Among 331 patients with low-to-moderate clinical probability of PE, sensitivity and clinical usefulness were 100 and 27.8% for CDD, respectively, and 100 and 36.5% for AADD, respectively. In 29 patients aged >50 with CDD >500 ng/mL, AADD ...Continue Reading

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Oct 24, 2014·VASA. Zeitschrift für Gefässkrankheiten·Julio FloresIgnacio Arribas

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Citations

Feb 8, 2019·Internal and Emergency Medicine·Elisa GesuElisa Ceriani
Aug 2, 2017·Emergency Medicine Australasia : EMA·Imogen AckerlyAnne-Maree Kelly
Nov 25, 2021·Journal of Primary Care & Community Health·Kenneth IwujiDuke Appiah

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