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Use of the D-dimer in the evaluation of suspected pulmonary embolism (PE) has evolved, and diagnostic thresholds have been moved upwards in select populations. Recently, the YEARS algorithm was shown to be safe using a threshold of 1000 μg/L in patients without hemoptysis, deep vein thrombosis, or PE as the most likely diagnosis (NEJM JW Emerg Med Jul 2017 and Lancet 2017; 390:289). Other researchers have proposed gestational age-adjusted D-dimers in pregnancy.
To test their hypothesis that the low prevalence of PE in Japanese populations warrants a higher D-dimer threshold, researchers retrospectively reviewed records for 395 patients with suspected PE at one Japanese emergency department from 2013 to 2017; non-Japanese patients were exclud…