Can Age-Adjusted d-Dimer Cutoffs Accurately Rule Out DVT?

In patients with low or intermediate likelihood of deep vein thrombosis (DVT) based on clinical assessment, d-dimer testing is often used to exclude DVT, but false-positive results increase with age. Age-adjusted d-dimer cutoffs are well established for ruling out pulmonary embolism in patients aged 50 years and older, but whether they can also rule out DVT is unclear.

In a multinational prospective study, researchers evaluated 3200 adults (median age, 59 years) presenting to emergency departments (EDs) with suspected lower-extremity DVT. Physicians assessed pretest probability of DVT using the Wells score. Patients with low or intermediate probability underwent d-dimer testing. Those with an elevated d-dimer (defined as >500 μg/l in …