title: Age-Dependent D-dimer Cut-off to Avoid Unnecessary CT-Exams for Ruling-out Pulmonary Embolism.
abstract: OBJECTIVE
  To evaluate the effect of an age-dependent D-Dimer cut-off in patients who underwent a computed tomography pulmonary angiogram (CTPA) for suspected pulmonary embolism (PE) Material and Methods: Retrospective application of an age-dependent D-dimer cut-off (age/100 in patients aged over 50) in 530 consecutive patients, both in- and outpatients, aged over 18, who underwent CTPA for suspected PE according to the guidelines.
  
  
  RESULTS
  The application of an age-dependent D-dimer cut-off showed a now negative test-result in 17 of 530 patients (3.2%). The proportion was 4.1% (17 of 418) in patients aged over 50. None of these 17 cases was diagnosed with PE in CTPA, the false-negative rate was 0%. The effect could be seen in outpatients (14 of 377 [3.7%]) as well as in inpatients(3 of 153 [2.0%]) with no statistically significant difference (p > 0.05).
  
  
  CONCLUSIONS
  The application of an age-dependent D-dimer cut-off as part of the guidline-based algorithm for suspected PE reduced the number of necessary CTPA in outpatients as well as in inpatients.
  
  
  CONCLUSIONS
  The application of an age-dependent D-dimer cut-off reduces the number of CTPA as part of the diagnostic algorithm in patients suspected for PENo reduction in diagnostic safety was found. The age adjustement performed equally in outpatients and inpatients
authors: Radiology, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors: M M
authors: MM
authors: Altmann
authors: Emergency Department, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors: C E
authors: CE
authors: Wrede
authors: Laboratory Medicine, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors: D
authors: D
authors: Peetz
authors: Radiology, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors: M
authors: M
authors: Höhne
authors: Radiology, University Medical Center, Regensburg, Germany.
authors: C
authors: C
authors: Stroszczynski
authors: Radiology, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors: T
authors: T
authors: Herold
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D000069342:Medical Overuse / Q000517:prevention & control* / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D011655:Pulmonary Embolism / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D019564:Unnecessary Procedures; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D