Featured Research

from universities, journals, and other organizations

Use of age-adjusted D-dimer levels to exclude lung blood clots

Date:
March 18, 2014
Source:
The JAMA Network Journals
Summary:
Using a patient's age to raise the threshold for an abnormal result of a blood test used to assess patients with a suspected pulmonary embolism (blood clot in lungs) appeared to be safe and led to fewer healthy patients with the diagnosis, according to a study. "Future studies should assess the utility of the age-adjusted cutoff in clinical practice. Whether the age-adjusted cutoff can result in improved cost-effectiveness or quality of care remains to be demonstrated," the authors conclude.

Using a patient's age to raise the threshold for an abnormal result of a blood test used to assess patients with a suspected pulmonary embolism (blood clot in lungs) appeared to be safe and led to fewer healthy patients with the diagnosis, according to a study in the March 19 issue of JAMA.

D-dimer is a breakdown product of a blood clot, and measuring D-dimer levels is one way doctors exclude a diagnosis of pulmonary embolism (PE). Several studies have shown that D-dimer levels increase with age. As a result, the proportion of healthy patients with abnormal test results (above 500 µg/L for most available commercial tests) increases with age, limiting the test's clinical usefulness in older people, according to background information in the article.

Marc Righini, M.D., of Geneva University Hospital, Geneva, Switzerland, and colleagues examined whether an age-adjusted D-dimer threshold, which involved redefining the test value that distinguished abnormal and normal results by multiplying the patient's age by 10 in patients 50 years or older, safely excluded the diagnosis of PE in elderly patients with suspected PE. The study, conducted at 19 centers in Belgium, France, the Netherlands, and Switzerland between January 2010 and February 2013, included outpatients who underwent a clinical probability assessment (measured by one of two scoring systems based on risk factors and clinical findings), D-dimer measurement, and computed tomography pulmonary angiography (CTPA; image of lungs).

Of the 3,346 patients with suspected PE included in the analysis, the prevalence of PE was 19 percent. The researchers found that combining the probability assessment with adjustment of the D-dimer cutoff for patient age safely excluded the diagnosis of PE and was associated with a low likelihood of subsequent PE or other venous blood clot. In elderly patients, there was an increase in the proportion of patients in whom PE could be excluded without further imaging.

"Future studies should assess the utility of the age-adjusted cutoff in clinical practice. Whether the age-adjusted cutoff can result in improved cost-effectiveness or quality of care remains to be demonstrated," the authors conclude.


Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Marc Righini, Josien Van Es, Paul L. Den Exter, Pierre-Marie Roy, Franck Verschuren, Alexandre Ghuysen, Olivier T. Rutschmann, Olivier Sanchez, Morgan Jaffrelot, Albert Trinh-Duc, Catherine Le Gall, Farès Moustafa, Alessandra Principe, Anja A. Van Houten, Marije Ten Wolde, Renée A. Douma, Germa Hazelaar, Petra M. G. Erkens, Klaas W. Van Kralingen, Marco J. J. H. Grootenboers, Marc F. Durian, Y. Whitney Cheung, Guy Meyer, Henri Bounameaux, Menno V. Huisman, Pieter W. Kamphuisen, Grégoire Le Gal. Age-Adjusted D-Dimer Cutoff Levels to Rule Out Pulmonary Embolism. JAMA, 2014; 311 (11): 1117 DOI: 10.1001/jama.2014.2135

Cite This Page:

The JAMA Network Journals. "Use of age-adjusted D-dimer levels to exclude lung blood clots." ScienceDaily. ScienceDaily, 18 March 2014. <www.sciencedaily.com/releases/2014/03/140318162919.htm>.
The JAMA Network Journals. (2014, March 18). Use of age-adjusted D-dimer levels to exclude lung blood clots. ScienceDaily. Retrieved August 21, 2014 from www.sciencedaily.com/releases/2014/03/140318162919.htm
The JAMA Network Journals. "Use of age-adjusted D-dimer levels to exclude lung blood clots." ScienceDaily. www.sciencedaily.com/releases/2014/03/140318162919.htm (accessed August 21, 2014).

Share This




More Health & Medicine News

Thursday, August 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Possible Ebola Patient in Isolation at California Hospital

Possible Ebola Patient in Isolation at California Hospital

Reuters - US Online Video (Aug. 20, 2014) — A patient who may have been exposed to the Ebola virus is in isolation at the Kaiser Permanente South Sacramento Medical Center. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Raw: World's Oldest Man Lives in Japan

Raw: World's Oldest Man Lives in Japan

AP (Aug. 20, 2014) — A 111-year-old Japanese was certified as the world's oldest man by Guinness World Records on Wednesday. Sakari Momoi, a native of Fukushima in northern Japan, was given a certificate at a hospital in Tokyo. (Aug. 20) Video provided by AP
Powered by NewsLook.com
Do More Wedding Guests Make A Happier Marriage?

Do More Wedding Guests Make A Happier Marriage?

Newsy (Aug. 20, 2014) — A new study found couples who had at least 150 guests at their weddings were more likely to report being happy in their marriages. Video provided by Newsy
Powered by NewsLook.com
Ebola-Hit Sierra Leone's Freetown a City on Edge

Ebola-Hit Sierra Leone's Freetown a City on Edge

AFP (Aug. 19, 2014) — Residents of Sierra Leone's capital voice their fears as the Ebola virus sweeps through west Africa. Duration: 00:56 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins