Pérez-Ong JE, Vera-Delgado JA

Language: Spanish
References: 6
Page: 24-27
PDF size: 381.66 Kb.

ABSTRACT

The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) rises exponentially with age. Around 65% of those diagnosed with this medical entities are 60 years or older. For the exclusion of DVT and PE in patients older than 50 years, the use of D-dimer is less specific. That is why it is necessary to evaluate the sensibility and specificity using an age-adjusted cut-off value. Methods: A retrospective analysis of D-dimer results was made in patients over 50 years old hospitalized in March-June 2013. The clinical probability was calculated using Wells score. The D-dimer analysis was performed with the Cardiac Reader by Roche Diagnostics^®. Sensitivity, specificity, positive predictive value and negative predictive value were calculated using the universal cut-off value (0.5 µg/mL) and the one proposed by Haas and his team (age-adjusted cut-off value). Results: Using the universal cut-off value, the sensitivity obtained was 100%, specificity 25% (CI 95% 0.13-0.36), positive predictive value (PPV) 13% and negative predictive value (NPV) 100%. Using the one proposed by Haas and his team, the sensitivity was 100%, specificity 36% (CI 95% 0.2-0.4), PPV 15%, NPV 100%. Conclusions: The use of an age-adjusted cut-off value and the combination with a low clinical probability (Wells score) greatly increase the proportion of older patients in whom DVT and PE can safely be excluded without needing further studies like compression ultrasonography.

REFERENCES

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