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Age-Adjusted D-Dimer in Ruling Out Acute Aortic Syndrome
Dayeon Lee1, Yong Won Kim1, Tae Youn Kim1
1Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea.
Emergency Medicine International
|February 16, 2022
Summary
An age-adjusted D-dimer test improves diagnostic accuracy for acute aortic syndrome (AAS). This method enhances specificity and positive predictive value (PPV) while maintaining high sensitivity for ruling out AAS.
Area of Science:
- Cardiology
- Emergency Medicine
- Diagnostic Biomarkers
Background:
- D-dimer is a potential biomarker for ruling out acute aortic syndrome (AAS).
- D-dimer levels naturally increase with age.
- The diagnostic utility of an age-adjusted D-dimer for AAS requires further investigation.
Purpose of the Study:
- To evaluate the diagnostic accuracy of an age-adjusted D-dimer cutoff for ruling out AAS.
- To compare the performance of age-adjusted D-dimer with the conventional D-dimer cutoff.
Main Methods:
- Retrospective observational study of adult patients with suspected AAS.
- Analysis of D-dimer levels and computed tomography angiography results.
- Calculation of diagnostic accuracy using conventional (0.5 μg/ml) and age-adjusted (age × 0.01 for patients >50 years) cutoffs.
Main Results:
- D-dimer levels were significantly higher in the AAS group compared to the non-AAS group.
- The age-adjusted D-dimer cutoff showed increased specificity (65.6%) and positive predictive value (PPV) (65.6%) compared to the conventional cutoff.
- Sensitivity (97.6%) and negative predictive value (NPV) (97.6%) remained high with the age-adjusted cutoff.
Conclusions:
- Age-adjusted D-dimer cutoff demonstrates improved specificity and PPV for ruling out AAS.
- This adjusted method maintains high sensitivity, making it a valuable tool in AAS diagnosis.
- The findings suggest that age adjustment enhances the reliability of D-dimer testing in AAS evaluation.
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