Reduced efficacy of clinical probability score and d‐dimer assay in elderly subjects suspected of having deep vein thrombosis

Abstract

d-dimer decreased with age: 12% in the highest quartile (>73AE8 years) versus 25% in younger patients (P ¼ 0AE00005). We therefore conclude that the combined strategy of a low/moderate PCP score with a normal d-dimer test is safe for excluding DVT in all age groups, but is less useful in the elderly.

High D-dimer levels are associated with poor prognosis in cancer patients

“…D-dimer levels are known to increase with age. 31 In multivariable analysis, after adjustment for age, we could confirm that the increased risk of mortality seen in cancer patients with elevated D-dimer levels was independent of our patients' age. The presence of metastases in patients with solid tumors included in our study, as expected, was another predictive parameter linked to poor prognosis.…”

Diagnostic value of D-dimer in outpatients with suspected deep venous thrombosis receiving oral anticoagulation

“…There is evidence that D-dimer is less useful for exclusion of DVT in this age group [11,12]. The prevalence of DVT was somewhat higher than that found in the previous report mentioned above (18.5 versus 13%) but well below those we have found for nonanticoagulated elderly patients (Table 1).…”

Clinical significance of a negative D‐dimer level in patients with confirmed venous thromboembolism. Findings from the RIETE Registry

“…Blood Ddimer is sensitive for PE but cannot be used without an estimate of patient pretest probability. On occasion, physicians interpret D-dimer values in isolation or fail to perform a probability assessment [3,4]. Recent work has focused on cardiac troponin in PE prognosis.…”

“…Findings from the RIETE Registry Although it is unusual, some patients with acute venous thromboembolism (VTE) may test negative for D-dimer [1]. The sensitivity of D-dimer testing for suspected VTE can be limited not only by the choice of the appropriate assay but also by some patient characteristics [2,3] …”

“…Findings from the RIETE Registry Although it is unusual, some patients with acute venous thromboembolism (VTE) may test negative for D-dimer [1]. The sensitivity of D-dimer testing for suspected VTE can be limited not only by the choice of the appropriate assay but also by some patient characteristics [2,3]. Using data from the RIETE Registry [4], we compared the sensitivities of different assays in, and the clinical characteristics of, VTE patients with negative D-dimer findings at baseline and those who tested positive.…”