Accuracy of D-Dimers to Rule Out Venous Thromboembolism Events across Age Categories

الملخص EN

Background.

Strategies combining pretest clinical assessment and D-dimers measurement efficiently and safely rule out venous thromboembolism events (VTE) in low- and intermediate-risk patients.

Objectives.

As process of ageing is associated with altered concentrations of coagulation markers including an increase in D-dimers levels, we investigated whether D-dimers could reliably rule out VTE across age categories.

Method.

We prospectively assessed the test performance in 1,004 patients visiting the emergency department during the 6-month period with low or intermediate risk of VTE who also received additional diagnostic procedures.

Results.

67 patients had VTE with D-dimers levels above the threshold, and 3 patients displayed D-dimers levels below the threshold.

We observed that specificity of D-dimers test decreased in an age-dependent manner.

However, sensitivity and negative predictive value remained at very high level in each age category including older patients.

Conclusion.

We conclude that, even though D-dimers level could provide numerous false positive results in elderly patients, its high sensitivity could reliably help physicians to exclude the diagnosis of VTE in every low- and intermediate-risk patient.