The value of age-adjusted D-dimer cut-off value in diagnosing deep vein thrombosis in elderly patients
10.3760/cma.j.issn.0253-3758.2013.11.011
- VernacularTitle:年龄校正的D-二聚体在老年深静脉血栓诊断中的价值
- Author:
Shun-Xin ZHANG
1
;
Jun-Lai LI
;
Cui LIU
;
Guo-Juan TAN
;
Xiao-Lin CAO
;
Jie WANG
Author Information
1. 解放军总医院南楼超声科
- Keywords:
Venous thrombosis;
Age factors;
D-dimer
- From:
Chinese Journal of Cardiology
2013;41(11):945-949
- CountryChina
- Language:Chinese
-
Abstract:
Objective To validate the value of age-adjusted D-dimer combined with clinical probability to confirm or exclude deep vein thrombosis (DVT) in elderly patients.Method Elderly patients (≥65 years) suspected with DVT were evaluated by Wells score and D-dimer test.All patients underwent ultrasonography examination except for patients with Wells score ＜ 2 and negative D-dimer test results.Conventional cut-off value is 500 μg/L,while age-adjusted cut-off value is set as patient's age × 10 μg/L.We compared the sensitivity and specificity using the 2 cut-off values in confirming or excluding the diagnoses of DVT.Results The study population consisted of 624 patients [mean age (76.4 ± 19.3) years],DVT was confirmed in 192 (30.8％) patients.Using Wells score model,326 patients(52.2％) were scored as unlikely DVT and DVT was confirmed by ultrasonography in 44 patients (13.5％),and 298 patients as likely DVT patients and DVT was confirmed in 148 patients (55.0％).The sensitivity,specificity,positive predictive value,and negative predictive value by conventional and age-adjusted D-dimer cut-off value for diagnosing DVT in low-risk patients evaluated by Wells score model were 95.5％,40.4％,20.0％,98.3％ and 95.5％,61.0％,27.6％,87.1％,respectively,and which were 89.9％,67.3％,73.1％,87.1％ and 89.2％,89.3％,89.2％,89.3/％,respectively,in high-risk patients evaluated by Wells score model.Thus,specificity increased about 20％ using age-adjusted D-dimer cut-off value compared with conventional D-dimer cut-off value.Conclusion The age-adjusted D-dimer cut-off value combined with clinical probability evaluation could increase diagnosing specificity of DVT in elderly patients.
