Ver el código de «Age adjusted D-dimer»

==Background==
*The [[PE]] derivation and validation study for usage of the [[EBQ:The ADJUST-PE Study|age adjusted d-dimer]] formula concluded that when combining the d-dimer adjustment with clinical probability, less patients required CTA for exclusion and offered no clinical increase in the rate of missed [[Pulmonary embolism]]<ref>Douma R. et al. Potential of an age adjusted D-dimer cut-off value to improve the exclusion of pulmonary embolism in older patients: a retrospective analysis of three large cohorts. BMJ (Clinical research ed.) (March 30). 2010. doi:10.1136/bmj.c1475.</ref><ref>Douma, R. et al. Using an age-dependent D-dimer cut-off value increases the number of older patients in whom deep vein thrombosis can be safely excluded. Haematologica, no. 10 (April 17). 2012. doi:10.3324/haematol.2011.060657.</ref>
*Similarly, using the age adjusted d-dimer in combination with clinical probability can reduce the need for further testing in DVT evaluations with no substantial risk to patient safety<ref>Schouten, H et al.. Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis. BMJ (Clinical research ed.) (May 3). 2013. doi:10.1136/bmj.f2492.</ref><ref>Schouten, H et al. Validation of two age dependent D-dimer cut-off values for exclusion of deep vein thrombosis in suspected elderly patients in primary care: retrospective, cross sectional, diagnostic analysis. BMJ (Clinical research ed.) (June 6). 2012. doi:10.1136/bmj.e2985.</ref><ref>Adams, D, et al. Clinical utility of an age-adjusted D-dimer in the diagnosis of venous thromboembolism. Ann Emerg Med. 2014; 64:232-234.</ref>

==Usage==
{{Age Adjusted D-dimer usage}}

{| {{table}}
| align="center" style="background:#f0f0f0;"|'''TEST'''
| align="center" style="background:#f0f0f0;"|'''Age'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
| align="center" style="background:#f0f0f0;"|'''Specificity'''
|-
| Lab cutoff||51 - 60||100%||57.60%
|-
| Lab cutoff ||61 - 70||99.00%||39.40%
|-
| Lab cuttoff||71 - 80||98.70%||24.50%
|-
| Lab cutoff ||>80||99.60%||14.70%
|-
| Age Adjusted cutoff||51 - 60||99.40%||62.30%
|-
| Age Adjusted cutoff ||61 - 70||97.30%||49.50%
|-
| Age Adjusted cutoff ||71 - 80||97.30%||44.20%
|-
| Age Adjusted cutoff ||>80||97.00%||35.20%
|}

==Special Considerations==
*Risk stratification for all patients should take place using the [[Wells Criteria]]
*Know your lab's assay cutoff and whether it is report as DDU or FEUs since the formula is different for the different assays

==See Also==
*[[D-dimer]]

==References==
<references/>

[[Category:Pulmonary]]
[[Category:Vascular]]