ReviewResearch and practice in thrombosis and haemostasis2026
Raising the D-dimer bar: a narrative review of the age-adjusted D-dimer threshold.
Review in Research and practice in thrombosis and haemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Incidence and risk factors of venous and arterial thromboembolism events in lung cancer patients treated with immune checkpoint inhibitors.Frontiers in pharmacology · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
D-dimers play a key role in diagnosing venous thromboembolism (VTE) due to high negative predictive value in excluding VTE in patients with a nonhigh clinical probability. However, D-dimer levels naturally increase with age, complicating their interpretation in elderly patients. To address this, an age-adjusted threshold multiplying the patient's age by 10 (μg/L), starting from age 50 years, has been proposed in several studies, to exclude the diagnosis of VTE in patients over 50 years with a nonhigh clinical probability. This narrative review discusses the establishment as well as the efficiency and safety of the age-adjusted threshold multiplying the patient's age by 10 (μg/L), with a focus on the HemosIL D-dimer assays. Overall, the age-adjusted D-dimer threshold has demonstrated enhanced specificity without compromising sensitivity in excluding VTE in patients with suspected pulmonary embolism and nonhigh clinical probability in emergency department settings. By improving specificity, reducing imaging reliance, and lowering costs, the age-adjusted threshold offers a cost-effective and efficient strategy for optimizing VTE management. However, real-world diagnostic strategy studies remain limited, particularly for deep vein thrombosis. Retrospective studies dominate this area, and the cautious stance of scientific societies reflects the absence of large-scale, prospective trials. Emerging evidence suggests the age-adjusted threshold may be as safe and efficient as the conventional approach for deep vein thrombosis exclusion. More than 30 commercial assays are available for D-dimer testing, and the age-adjusted threshold is not validated with all commercially available D-dimer techniques. This underscores the critical need for assay-specific validation before age-adjusted thresholds can be reliably integrated into routine clinical practice.
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