|Common Sense - AAEM Member Magazine|
Edited By: Jay Khadpe, MD FAAEM and Michael C. Bond, MD FAAEM
Originally Published: November/December 2016 Common Sense
The D-dimer test is an important and widespread tool to assess for venous thromboembolic disease (VTE) in low risk patients. The test has a high sensitivity and negative predictive value; however it is also prone to false positives. Additionally, as D-dimer levels naturally rise with age, the test may lead to more frequent false positives in the elderly than the general population. Recently several investigations examined age related refinements to the interpretation of D-dimer results to rule out VTE. For this month’s resident journal review, we review two retrospective studies and one prospective study that evaluate using age-adjusted D-dimer levels to increase its specificity while retaining its sensitivity. Verification of the results of studies could reduce the use of expensive imaging studies, reduce patient exposure to radiation and contrast, and prevent unnecessary hospital admissions and anticoagulation. These issues are particularly pertinent for the elderly population.