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D-dimères et suspicion d'embolie pulmonaire : seuil adapté à l'âge

Published in Revue médicale suisse. 2014, vol. 10, no. 446, p. 1908-1912
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.
Keywords Age FactorsAgedAged, 80 and overDiagnostic Techniques, Respiratory System/standardsFibrin Fibrinogen Degradation Products/analysisHumansPredictive Value of TestsPulmonary Embolism/blood/diagnosisReference Standards
PMID: 25438373
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Research group La maladie thromboembolique veineuse (808)
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ONGARO, Gioele et al. D-dimères et suspicion d'embolie pulmonaire : seuil adapté à l'âge. In: Revue médicale suisse, 2014, vol. 10, n° 446, p. 1908-1912. https://archive-ouverte.unige.ch/unige:87936

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Deposited on : 2016-10-04

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