Related Experiment Video
Updated: Apr 20, 2026
06:45
Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
17.2K
[Age-adjusted D-dimers and pulmonary embolism].
Revue Medicale Suisse
|December 3, 2014
Summary
In elderly patients, using an age-adjusted D-dimer cut-off improves pulmonary embolism (PE) diagnosis specificity. This reduces the need for further imaging tests like CTPA in older individuals.
Area of Science:
- Medical Diagnostics
- Clinical Medicine
- Biochemistry
Context:
- Plasma D-dimer testing is a primary diagnostic tool for pulmonary embolism (PE).
- Elderly patients exhibit reduced specificity of conventional D-dimer cut-offs for PE diagnosis.
- Conventional D-dimer cut-offs limit PE exclusion in patients over 80 to approximately 5%.
Purpose:
- To evaluate the clinical utility of an age-adjusted D-dimer cut-off in elderly patients with suspected pulmonary embolism.
- To enhance the specificity of D-dimer testing in older populations while maintaining sensitivity.
- To reduce the reliance on further diagnostic imaging, such as CTPA, for PE diagnosis in the elderly.
Summary:
- An age-adjusted D-dimer cut-off (age x 10 for patients >50 years) significantly increases test specificity in elderly individuals.
- This adjusted cut-off maintains diagnostic sensitivity for pulmonary embolism.
- Implementation of the age-adjusted cut-off markedly decreases the necessity for advanced imaging like CTPA.
Impact:
- Improved diagnostic accuracy for pulmonary embolism in the elderly population.
- Reduced healthcare costs and patient exposure to radiation from unnecessary CTPA scans.
- Enhanced clinical management strategies for suspected PE in older adults through more reliable D-dimer interpretation.
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
727
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
727
01:19Pulmonary Embolism I: Introduction
19
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
19
01:29Pulmonary Embolism I: Introduction
1.4K
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
1.4K
01:27Pulmonary Embolism III: Nursing Management
717
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
717
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
451
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
451
01:29Venous Thrombosis III: Interprofessional Care
477
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
477