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Measurement of plasma D-dimer allows pulmonary embolus (PE) to be ruled out when clinical suspicion is low or moderate, but interpretation is complicated by the fact that d-dimer levels rise normally with age. In a multicenter European study, investigators prospectively evaluated the accuracy of an age-adjusted D-dimer cutoff in 2898 patients with low or moderate clinical probability for PE.
For patients aged 50 and older, a d-dimer result was considered negative if it was less than age ×10; for younger patients, the cutoff was fixed at 500 µg/mL. Patients with a positive result underwent computed tomographic pulmonary angiography (CT-PA). All patients were followed for 3 months. The use of the age-adjusted cutoff resulted in a 12% absolute …