Abstract Number: PB2283
Meeting: ISTH 2020 Congress
Background: D-dimer measurement is an important step in the diagnostic strategy of clinically suspected acute pulmonary embolism (PE) or deep venous thrombosis (DVT), but its clinical usefulness is limited in elderly patients.
Aims: The aim of our work is to verify the implementation of the age-dependent D-dimer cut-off value in conjunction with the evaluation of pre-analytical sample conditions to increase the diagnostic specifity of D-dimer in elderly patients suspected for PE and DVT.
Methods: All consecutive outpatients who were presented to the emergency department with clinically suspected PE or DVT were assessed by a sequential diagnostic strategy based on the clinical probability. They underwent highly sensitive D-dimer measurement with detection preanalytical conditions and the positive D-dimer finding was verified by imaging method (duplex sonography of the lower extremity veins or computed tomography angiography). D-dimer was be detected by HemosIL D-Dimer HS test with monitoring preanalytical condition by HIL modul on ACL TOP 750 CTS system.
Results: In 1952 patients with presumed PE or DVT included, the prevalence of DDIM positivity was 67.1% with fixed cut-off vs. 100%. 59.4% with age adjusted cut-off. The highest difference was in the age group of 70 years and over, where it formed 22.2% in the age group up to 75 years respectively. 18.6% up to 80 years. The measurement of preanalytic conditions led to only 1% improvement in negative prediction. However, this also represents in our group 20 patients who do not have to undergo time-consuming and more expensive imaging examinations.
Conclusions: Compared with a fixed D-dimer cut-off, the combination of pretest clinical probability assessment with age-adjusted D-dimer cut-off was associated with a larger number of patients in whom PE and DVT could be considered ruled out with a low likelihood of subsequent clinical venous thromboembolism.
Supported by: Grant LF-2020-002 and MH CZ – DRO (FNOl, 00098892)
To cite this abstract in AMA style:Prochazkova J, Slavik L, Ulehlova J, Kaminkova J, Chalupnikova P, Krcova V, Hlusi A. A Combination of Age Adjusted Cut-Off and Preanalytical Conditions Monitoring for Increased DDIM Assay Specificity [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/a-combination-of-age-adjusted-cut-off-and-preanalytical-conditions-monitoring-for-increased-ddim-assay-specificity/. Accessed January 27, 2022.
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