Author Interviews, Blood Clots, CHEST / 18.05.2014
Pulmonary Embolism: Evaluation of Age-Adjusted Threshold of D-Dimer Blood Test
MedicalResearch.com Interview with
Scott C. Woller, MD
Co-Director Thrombosis Program
Intermountain Medical Center
Associate Professor of Internal Medicine
University of Utah School of Medicine
Murray, UT 84157-7000
Dr. Woller: By way of background, D-dimer, a simple blood test that is used to investigate the diagnosis of suspected pulmonary embolism (PE), and it increases with age. Recent research suggests that the use of an age-adjusted d-dimer threshold may improve diagnostic efficiency without compromising safety. We wished to assess the safety of using an age-adjusted d-dimer threshold in the work-up of patients with suspected pulmonary embolism.
MedicalResearch: What are the main findings of the study?
Dr. Woller: In this retrospective cohort study we identified 923 patients age > 50 years who presented to our emergency department with suspected pulmonary embolism, and had their pretest probability of PE calculated along with a d-dimer performed. All patients underwent computed tomography pulmonary angiography (CTPA). We observed that among patients unlikely to have PE, adoption of an age-adjusted D-dimer cut-off (compared with a conventional D-dimer cut-off) reduced the need for CTPA in an additional 18.3% of patients, and was associated with a low 90-day rate of failure to diagnose PE.
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