title: [Age-adjusted D-dimers and pulmonary embolism].
abstract: Plasma D-dimer measurement is the first diagnostic test performed in patients with a non-high or an unlikely clinical probability of pulmonary embolism (PE) but its clinical usefulness is limited in elderly patients due to a low specificity in this subgroup. PE can be excluded based on D-dimers and clinical probability only in about 5% of patients over 80 years when using the conventional cut-off. Age-adjusted D-dimer cut-off (adjusted cut-off value = age x 10 in patients over 50) increases the specificity of the test without significantly reducing its sensitivity. Using the age-adjusted D-dimer cut-off markedly reduces the need for further diagnostic studies such as computed tomography pulmonary angiography (CTPA). The age-adjusted cut-off has been widely validated in retrospective cohorts, and more recently in a prospective management study.
authors.forename: G
authors.initials: G
authors.lastname: Ongaro
authors.forename: M
authors.initials: M
authors.lastname: Righini
authors.forename: A
authors.initials: A
authors.lastname: Perrier
authors.forename: C
authors.initials: C
authors.lastname: Marti
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003948:Diagnostic Techniques, Respiratory System / Q000592:standards; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis*; D012015:Reference Standards
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D