Our study shows that age-adjusted D-dimer had low nLR, allowing its use as a rule-out PE strategy in non-high pretest clinical probability patients, as well as using Vidas(®), Liatest(®) or MDA(®) assays. This age-adjusted cut-off increased clinical usefulness of D-dimer in older patients. A large prospective study is required to confirm these results.
, Torbicki A., Perrier A., Konstantinides S., Agnelli G., Galie N., Pruszczyk P., Bengel F., Brady A. J.B., Ferreira D., Janssens U., Klepetko W., Mayer E., Remy-Jardin M., Bassand J.-P., Vahanian A., Camm J., De Caterina R., Dean V., Dickstein K., Filippatos G., Funck-Brentano C., Hellemans I., Kristensen S. D., McGregor K., Sechtem U., Silber S., Tendera M., Widimsky P., Zamorano J. L., Zamorano J.-L., Andreotti F., Ascherman M., Athanassopoulos G., De Sutter J., Fitzmaurice D., Forster T., Heras M., Jondeau G., Kjeldsen K., Knuuti J., Lang I., Lenzen M., Lopez-Sendon J., Nihoyannopoulos P., Perez Isla L., Schwehr U., Torraca L., Vachiery J.-L., , , Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC), 10.1093/eurheartj/ehn310
DI NISIO M., SQUIZZATO A., RUTJES A. W. S., BÜLLER H. R., ZWINDERMAN A. H., BOSSUYT P. M. M., Diagnostic accuracy of D-dimer test for exclusion of venous thromboembolism: a systematic review, 10.1111/j.1538-7836.2007.02328.x
Roy P.-M., Systematic review and meta-analysis of strategies for the diagnosis of suspected pulmonary embolism, 10.1136/bmj.331.7511.259
RIGHINI M., PERRIER A., DE MOERLOOSE P., BOUNAMEAUX H., D-Dimer for venous thromboembolism diagnosis: 20 years later, 10.1111/j.1538-7836.2008.02981.x
Carrier, Thromb Haemost, 101, 886 (2009)
Kabrhel Christopher, Mark Courtney D., Camargo Carlos A., Plewa Michael C., Nordenholz Kristen E., Moore Christopher L., Richman Peter B., Smithline Howard A., Beam Daren M., Kline Jeffrey A., Factors Associated With Positive D-dimer Results in Patients Evaluated for Pulmonary Embolism : FACTORS ASSOCIATED WITH POSITIVE D-DIMERS, 10.1111/j.1553-2712.2010.00765.x
Sohne, Thromb Haemost, 94, 206 (2005)
RIGHINI M., NENDAZ M., LE GAL G., BOUNAMEAUX H., PERRIER A., Influence of age on the cost-effectiveness of diagnostic strategies for suspected pulmonary embolism : Age and cost-effective diagnosis of pulmonary embolism, 10.1111/j.1538-7836.2007.02667.x
Aguilar, Haematologica, 86, E28 (2001)
Righini, Thromb Haemost, 85, 744 (2001)
Douma R. A., le Gal G., Sohne M., Righini M., Kamphuisen P. W., Perrier A., Kruip M. J. H. A., Bounameaux H., Buller H. R., Roy P. M., Potential of an age adjusted D-dimer cut-off value to improve the exclusion of pulmonary embolism in older patients: a retrospective analysis of three large cohorts, 10.1136/bmj.c1475
Roy Pierre-Marie, Meyer Guy, Vielle Bruno, Le Gall Catherine, Verschuren Franck, Carpentier Françoise, Leveau Philippe, Furber Alain, , Appropriateness of Diagnostic Management and Outcomes of Suspected Pulmonary Embolism, 10.7326/0003-4819-144-3-200602070-00003
Roy Pierre-Marie, A Computerized Handheld Decision-Support System to Improve Pulmonary Embolism Diagnosis : A Randomized Trial, 10.7326/0003-4819-151-10-200911170-00003
KLINE J. A., COURTNEY D. M., KABRHEL C., MOORE C. L., SMITHLINE H. A, PLEWA M. C., RICHMAN P. B., O'NEIL B. J., NORDENHOLZ K., Prospective multicenter evaluation of the pulmonary embolism rule-out criteria : Prospective multicenter evaluation of the PERC, 10.1111/j.1538-7836.2008.02944.x
Pepe M. S., Limitations of the Odds Ratio in Gauging the Performance of a Diagnostic, Prognostic, or Screening Marker, 10.1093/aje/kwh101
Stein Paul D., Fowler Sarah E., Goodman Lawrence R., Gottschalk Alexander, Hales Charles A., Hull Russell D., Leeper Kenneth V., Popovich John, Quinn Deborah A., Sos Thomas A., Sostman H. Dirk, Tapson Victor F., Wakefield Thomas W., Weg John G., Woodard Pamela K., Multidetector Computed Tomography for Acute Pulmonary Embolism, 10.1056/nejmoa052367
PENALOZA A., KLINE J., VERSCHUREN F., COURTNEY D. M., ZECH F., DERRIEN B., VIELLE B., ARMAND-PERROUX A., THYS F., ROY P.-M., European and American suspected and confirmed pulmonary embolism populations: comparison and analysis : European and American PE, 10.1111/j.1538-7836.2012.04631.x
Bounameaux H., Contemporary management of pulmonary embolism: the answers to ten questions : Review: Contemporary management of pulmonary embolism, 10.1111/j.1365-2796.2010.02254.x
Kearon, CMAJ, 168, 183 (2003)
KLINE J. A., HOGG M. M., COURTNEY D. M., MILLER C. D., JONES A. E., SMITHLINE H. A., D-dimer threshold increase with pretest probability unlikely for pulmonary embolism to decrease unnecessary computerized tomographic pulmonary angiography : Elevated D-dimer threshold, 10.1111/j.1538-7836.2012.04647.x
Stein Paul D., Goodman Lawrence R., Hull Russell D., Dalen James E., Matta Fadi, Diagnosis and Management of Isolated Subsegmental Pulmonary Embolism: Review and Assessment of the Options, 10.1177/1076029611422363
Bibliographic reference
Penaloza, A ; Roy, P-M ; Kline, J ; Verschuren, F ; LE Gal, G ; et. al. Performance of age-adjusted D-dimer cut-off to rule out pulmonary embolism.. In: Journal of thrombosis and haemostasis : JTH, Vol. 10, no.7, p. 1291-6 (2012)