Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis

Juergen H. Prochaska, Bernd Frank, Markus Nagler, Heidrun Lamparter, Gerhard Weisser, Andreas Schulz, Lisa Eggebrecht, Sebastian Goebel, Natalie Arnold, Marina Panova-Noeva, Iris Hermanns, Antonio Pinto, Stavros Konstantinides, Hugo ten Cate, Karl J. Lackner, Thomas Muenzel, Christine Espinola-Klein, Philipp S. Wild*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Web of Science)

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 languageEnglish
Article number4591
Number of pages10
JournalScientific Reports
Volume7
DOIs
Publication statusPublished - 4 Jul 2017

Keywords

  • C-REACTIVE PROTEIN
  • PULMONARY-EMBOLISM
  • VENOUS THROMBOSIS
  • ANTITHROMBOTIC THERAPY
  • PERFORMANCE
  • RISK
  • THROMBOEMBOLISM
  • GUIDELINES
  • ACCURACY
  • DISEASE

Cite this