ArticleMedizinische Klinik, Intensivmedizin und Notfallmedizin2014
[Age-adjusted D-dimer cut-offs to diagnose thromboembolic events: validation in an emergency department].
Article in Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 18 citations in OpenAlex.
- Raising the D-dimer bar: a narrative review of the age-adjusted D-dimer threshold.Research and practice in thrombosis and haemostasis · 2026Review
- Role of combining anticoagulant and antiplatelet agents in COVID-19 treatment: a rapid review.Open heart · 2021Review
- [Prevalence and severity of pulmonary embolism are dependent on clinical and paraclinical parameters : Analysis of 1,943 consecutive patients with CT pulmonary angiography].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2017Article
- [Filling defect of the pulmonary artery?].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2015Article
- Impact of d-Dimers on the Differential Diagnosis of Acute Chest Pain: Current Aspects Besides the Widely Known.Clinical Medicine Insights. Cardiology · 2014Review
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn elderly patients, an unspecific increase of fibrin degradation products in blood is observed. Thus, the D-dimer test to rule out thromboembolic events has a high false-positive rate in elderly patients. Our aim was to validate an age-adjusted D-dimer cut-off and to assess its utility in elderly patients.
methodsIn a retrospective cohort of outpatients (n = 1033) presenting to our emergency department with suspected acute pulmonary embolism and/or deep vein thrombosis (PE/DVT), age-adjusted D-dimer cut-off values were derived using receiver operating characteristic (ROC) curve analysis. Subsequently, the proportion of patients with normal D-dimer and false-negative test results, respectively, and the number needed-to-test (NNT) were compared for conventional and age-adjusted cut-off values.
resultsUsing the conventional cut-off of 0.5 mg/dl, PE/DVT could be excluded in 68 % of patients, whereas the age-adjusted cut-off [(age × 0.016) mg/l] ruled out 77 % of patients. Particularly in patients > 70 years, the negative prediction accuracy of excluding a PE/DVT increased explicitly. The failure rate of the age-adjusted cut-off value was 0.8 % (95 % confidence interval 0.3-1.6 %).
conclusionThe age-adjusted D-dimer cut-off point increases the proportion of older patients, in whom an acute thromboembolic event can be excluded.
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