Comparison of age-adjusted critical and conventional cut-off values of D-dimer in the diagnosis of pulmonary thromboembolism in elderly patients
10.3969/j.issn.1673-4130.2017.17.014
- VernacularTitle:D-二聚体年龄校正阈值与传统阈值在老年肺血栓栓塞症诊断中的应用价值比较
- Author:
Yun CAO
;
Xiaoyan ZHANG
;
Deyong CAO
;
Rui ZHANG
;
Tiantian XIN
- Keywords:
pulmonary embolism;
D-dimer;
age-adjusted;
thresholds
- From:
International Journal of Laboratory Medicine
2017;38(17):2371-2373
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnostic value of D-dimer age-adjusted threshold in elderly patients with Pulmonary thromboembolism(PTE).Methods Collected patients older than 50 years of suspected PTE,who visited Yan′an People′s Hospital and the Hospital Affiliated to Yan′an University from June 2015 to September 2016,using the revised Geneva criteria for clinical probability assessment firstly.The low-risk group was excluded from the study;the patients with moderate-to-high risk were performed D-dimer detection and CTPA.All patients determined both by D-dimer age-adjusted thresholds and traditional thresholds,comparing the diagnostic efficacy of the two methods subsequently.Results 163 patients were diagnosed with PTE by CTPA among the 549 subjects,the positive rate was 29.69％.The diagnostic sensitivity of plasma D-dimer was 83.44％,78.53％,the specificity was 17.88％,31.61％ respectively,the missed diagnosis rate was 16.56％,21.47％,respectively.The misdiagnosis rates were 82.12％ and 68.39％,respectively,and the Younden index was 0.013 2 and 0.101 4 respectively.All subjects were divided into four groups according to age:50-60 years,60-70 years,70-80 years,and equal or greater than 80 years age group.Compared with the traditional threshold,the misdiagnosis rates of the four groups of age-adjusted thresholds decreased by 4.00％,15.70％,21.36％ and 17.39％,respectively and the specificity was increased by 1.23,1.65,2.56 and 3.00 times,respectively.Conclusion The diagnostic accuracy of the age-corrected threshold is higher than the traditional threshold;combined with clinical practice,the optimal threshold is determined by the ROC curve,the clinician can serve as a reference.
