ArticleInternational journal of laboratory hematology2026
Out With the Old, in With the New: Age-Related D-Dimer Thresholds.
Article in International journal of laboratory hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundA fixed D-dimer cut-off threshold of 0.500 μg/mL is used in Blackrock Health Hermitage Clinic (BHHC) and most Haematology laboratories across Ireland, however, international guidelines have evolved over the past decade, and a growing body of evidence supports the use of age-adjusted D-dimer thresholds. This study evaluates the appropriateness of age-adjusted cut-offs in the patient population served by BHHC. Notably, inconsistent adherence to a formal hospital policy for the screening and diagnosis of venous thromboembolism (VTE) was observed throughout the clinical areas; the potential benefits of implementing such a policy are discussed herein. The integration of age-adjusted D-dimer thresholds with a validated clinical probability assessment tool may reduce unnecessary diagnostic imaging in patients investigated for VTE and prevent D-dimer testing in those deemed to have a 'likely' pre-test probability of VTE.
methodsA cross-sectional study was conducted to determine age-related D-dimer thresholds in a representative sample of patients attending BHHC. D-dimer measurements were performed using the ACL TOP 350 coagulation analyser with HemosIL D-dimer HS 500 reagents. Statistical analysis was carried out using IBM SPSS (v29) and Microsoft Excel. Ethical approval was obtained from the BHHC Clinical Governance Committee.
resultsAn age-related increase in D-dimer levels was observed. Applying an age-adjusted threshold (defined as patient age × 0.01 μg/mL for individuals aged 50 years and older) reduced false-positive results by 12.6% in this age group.
conclusionAge-adjusted D-dimer thresholds are recommended, provided they are combined with a validated clinical probability assessment tool, such as the two-level Wells score. This approach improves diagnostic specificity and may reduce unnecessary imaging, particularly in older adults.
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