Abstract
Previous reports have investigated the impact of age on D-Dimer testing in elderly individuals with suspected deep vein thrombosis (DVT), but data on the age-related diagnostic value of D-dimer in a sample covering a broad age range are limited. The present study determined age-specifically the diagnostic accuracy of D-dimer and compared it to C-reactive protein (CRP), a marker of inflammation, in 500 patients with suspected DVT from the VTEval project (NCT02156401). Sensitivity of D-dimer was lower in patients <60 years in comparison to patients >= 60 years (Delta-16.8%), whereas specificity was 27.9% higher. Lowest levels of sensitivity were detected for female sex, unprovoked DVT, low thrombotic burden, and distal DVT. A fixed D-dimer threshold of 0.25 mg/L FEU resulted in elevated sensitivity for patients <60 with a reduction of false negatives by 40.0% for proximal DVT and by 50.0% for distal DVT. In patients <60 years, D-dimer and CRP demonstrated comparable diagnostic performance for both proximal and distal DVT (p > 0.05). In conclusion, these data outline a clinically-relevant limitation of D-dimer testing among younger patients with suspected DVT indicating a necessity for age-adapted cut-off values. Further research is required to decrypt the role of inflammation in the pathophysiology and diagnosis of venous thrombosis.
Original language | English |
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Article number | 4591 |
Number of pages | 10 |
Journal | Scientific Reports |
Volume | 7 |
DOIs | |
Publication status | Published - 4 Jul 2017 |
Keywords
- C-REACTIVE PROTEIN
- PULMONARY-EMBOLISM
- VENOUS THROMBOSIS
- ANTITHROMBOTIC THERAPY
- PERFORMANCE
- RISK
- THROMBOEMBOLISM
- GUIDELINES
- ACCURACY
- DISEASE