Related Experiment Video

Updated: Feb 22, 2026

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
06:45

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Published on: February 10, 2023

16.5K

No added value of the age-adjusted D-dimer cut-off to the YEARS algorithm in patients with suspected pulmonary

L M van der Pol1,2, T van der Hulle1, Y W Cheung3

  • 1Department Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.

Journal of Thrombosis and Haemostasis : JTH
|September 24, 2017
PubMed

Insights

The YEARS algorithm efficiently diagnoses pulmonary embolism (PE). Adding the age-adjusted D-dimer (ADJUST) strategy did not improve diagnostic efficiency or reduce imaging in this study.

Area of Science:

  • Medical Diagnostics
  • Cardiology
  • Pulmonary Medicine

Background:

  • Pulmonary embolism (PE) diagnosis often requires imaging like CTPA.
  • The YEARS algorithm simplifies PE diagnosis and reduces CTPA use.
  • Age-adjusted D-dimer (ADJUST) is another strategy to reduce CTPA in patients 50+.

Purpose of the Study:

  • To evaluate if combining the YEARS algorithm with ADJUST improves CTPA reduction.
  • To assess the impact on diagnostic accuracy and missed PE cases.

Main Methods:

  • Post hoc analysis of 3465 patients managed with the YEARS algorithm.
  • Compared CTPA rates and diagnostic failures under different YEARS-ADJUST combinations.
  • Assessed 3-month venous thromboembolism (VTE) follow-up.

Main Results:

  • The YEARS algorithm alone managed 48% of patients without CTPA, with a 0.61% VTE failure rate.
  • Integrating ADJUST into YEARS would manage 47% without CTPA, but increase missed diagnoses.
  • No tested YEARS-ADJUST combination showed significant efficiency gains without increasing missed PE.

Conclusions:

  • Implementing ADJUST within the YEARS algorithm provided no added value in this cohort.
  • The combination did not improve CTPA reduction or diagnostic safety.
  • YEARS algorithm alone appears efficient for PE diagnosis.

Keywords:
D-dimerclinical decision rulecomputed tomographydiagnosisvenous thromboembolism

More Related Videos

Establishment of a Minimally Invasive Rat Model of Pulmonary Embolism Using Autologous Blood Clots08:02

Establishment of a Minimally Invasive Rat Model of Pulmonary Embolism Using Autologous Blood Clots

Published on: October 25, 2024

886
A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis10:26

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

Published on: June 2, 2015

18.0K

Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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...
532
Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

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...
491
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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...
397
Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

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...
938
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

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...
367
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.1K