Diagnosing Pulmonary Embolism: Using Age-Adjusted D-Dimer Cutoff Levels

Marc Righini, MD Division of Angiology and Hemostasis Geneva University Hospital, Geneva, SwitzerlandMedical Research.com Interview with:
Marc Righini, MD
Division of Angiology and Hemostasis
Geneva University Hospital, Geneva, Switzerland


MedicalResearch.com: What are the main findings of this study?

Dr. Righini: The study shows that when compared with a fixed D-Dimer cutoff of 500 ng/ml, the combination of pretest clinical probability assessment with age-adjusted D-dimer cut-off was associated  with a larger number of patients in whom Pulmonary Embolism  could be excluded, with a low likelihood of recurrent VTE. The benefit was the most important in patients  75 years or older, in whom using the age-adjusted cutoff instead of the 500 ng/ml cutoff increased five-fold the proportion of patients in whom PE could be excluded on the basis of D-dimer measurement.
MedicalResearch.com: Were any of the findings unexpected?

Dr. Righini: These findings were not unexpected as our retrospective analysis on more than 5000 with suspected PE Pulmonary Embolism suggested a potential interest of the adjusted D-dimer cut-off.

MedicalResearch.com: What should patients and clinicians take away from this report?

Dr. Righini: The age adjusted D-dimer cut-off, defined as age per 10 in patients 50 years or more, is associated with an increased yield of the D-dimer test in elderly patients.

MedicalResearch.com: What future research do you recommend as a result of this study?

Dr. Righini: Overall, the age-adjusted D-dimer cut off has been tested retrospectively in many different clinical settings in more than 10.000 patients and the ADJUST-PE study brings also a prospective confirmation of the interest of the cut-off. Whether the age-adjusted cutoff can result in improved cost-effectiveness or quality of care remains to be demonstrated.


Age-Adjusted D-Dimer Cutoff Levels to Rule Out Pulmonary Embolism: The ADJUST-PE Study


Last Updated on March 19, 2014 by Marie Benz MD FAAD