Kelly Broen1, Brian Scholtes2, Renée Vossen3. 1. Laboratory of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands. Electronic address: kellybroen@gmail.com. 2. Department of Internal Medicine, Zuyderland Medical Center, Sittard-Geleen, The Netherlands. 3. Laboratory of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands.
Abstract
INTRODUCTION: Negative D-dimer values combined with clinical decision rules by Wells can help in excluding the diagnosis deep vein thrombosis (DVT). However, with increasing age D-dimer levels increase, possibly leading to false positive results. MATERIALS AND METHODS: In this prospective study we compared the specificity and sensitivity of conventional D-dimer levels and age adjusted D-dimer levels in the diagnosis of DVT. We included 528 patients, all over 50years of age, of whom 117 had a DVT confirmed by duplex ultrasound. RESULTS AND CONCLUSION: Age adjusted D-dimer cut-off values had higher specificity compared to conventional D-dimer values (24.6% vs. 8.5%) as well as a higher negative predictive value (91,8% vs. 89,7%). Therefore we conclude that age adjusted D-dimer levels could be used to exclude the diagnosis of DVT. Ultimately this could lead to the performance of less duplex ultrasounds reducing health care costs and discomfort for the patient.
INTRODUCTION: Negative D-dimer values combined with clinical decision rules by Wells can help in excluding the diagnosis deep vein thrombosis (DVT). However, with increasing age D-dimer levels increase, possibly leading to false positive results. MATERIALS AND METHODS: In this prospective study we compared the specificity and sensitivity of conventional D-dimer levels and age adjusted D-dimer levels in the diagnosis of DVT. We included 528 patients, all over 50years of age, of whom 117 had a DVT confirmed by duplex ultrasound. RESULTS AND CONCLUSION: Age adjusted D-dimer cut-off values had higher specificity compared to conventional D-dimer values (24.6% vs. 8.5%) as well as a higher negative predictive value (91,8% vs. 89,7%). Therefore we conclude that age adjusted D-dimer levels could be used to exclude the diagnosis of DVT. Ultimately this could lead to the performance of less duplex ultrasounds reducing health care costs and discomfort for the patient.