UNIGE document Scientific Article
previous document  unige:32983  next document
add to browser collection

Adapting the D-dimer cutoff for thrombosis detection in elderly outpatients

Andro, Marion
Le Gal, Grégoire
Published in Expert review of cardiovascular therapy. 2013, vol. 11, no. 6, p. 751-9
Abstract D-dimer measurement is an important step in diagnostic strategies for venous thromboembolism. It allows the safe ruling out of the diagnosis with no need for imaging tests in approximately 30% of outpatients. However, the usefulness of d-dimer is limited in elderly patients; the likelihood of a negative d-dimer strongly decreases with age, making physicians reluctant to order the test. Several attempts to improve the performance of D-dimer in elderly patients have been pursued. Recently, an age-adjusted cutoff was derived; the optimal cutoff value (in µg/l) appears to be equal to the patient's age (in years) multiplied by ten in patients over 50 years of age with a low pretest clinical risk of venous thromboembolism. This age-adjusted cutoff value has been extensively and externally validated in retrospective studies that included mostly outpatients with suspected deep vein thrombosis or pulmonary embolism and used various quantitative D-dimer assays. All available studies confirmed the increased usefulness and similar safety of the age-adjusted cutoff compared with the conventional cutoff, the most important benefit being obtained in elderly patients. However, before any recommendation for clinical practice can be made, a prospective diagnostic management outcome study is lacking, in which all low clinical risk patients with D-dimer levels below their age-adjusted cutoff would be left untreated with no further diagnostic testing.
PMID: 23750684
Full text
This document has no fulltext available yet, but you can contact its author by using the form below.
Research group La maladie thromboembolique veineuse (808)
(ISO format)
ANDRO, Marion, RIGHINI, Marc Philip, LE GAL, Grégoire. Adapting the D-dimer cutoff for thrombosis detection in elderly outpatients. In: Expert review of cardiovascular therapy, 2013, vol. 11, n° 6, p. 751-9. doi: 10.1586/erc.13.51 https://archive-ouverte.unige.ch/unige:32983

437 hits

0 download


Deposited on : 2014-01-09

Export document
Format :
Citation style :