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In patients with suspected venous thromboembolism (VTE), imaging is indicated if blood d-dimer concentrations are higher than the conventional cutoff (500 µg/L). However, d-dimer concentrations increase with age, resulting in more false-positive results in older patients. Indeed, evidence suggests that an age-adjusted cutoff (age × 10 µg/L) is more specific than the conventional cutoff (JW Gen Med Jul 10 2012). In this meta-analysis, investigators in the Netherlands assessed the diagnostic accuracy of conventional versus age-based d-dimer cutoffs in older patients (age, >50) with suspected VTE (either pulmonary embolism or deep venous thrombosis).
Investigators reviewed data from 13 cohorts that included 12,497 patients with “non-high clinic…