Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Age‐Related Reduction of D‐Dimer Cut‐Off Level Specificity: Diagnostic Relevance in Geriatric Patients

Francesca Marchegiani
* ORCID logo ,
Roberta Galeazzi
ORCID logo ,
Fausto Moroni
,
Stefania Appolloni
,
Antonio Cherubini
,
Fabio Salvi
ORCID logo ,
Sara Cecchini
,
Enrico Paci
ORCID logo ,
Andrea Evangelisti
,
Fabiola Olivieri
,
Jacopo Sabbatinelli
ORCID logo ,
Antonio Domenico Procopio
Version 1 : Received: 17 May 2024 / Approved: 20 May 2024 / Online: 20 May 2024 (12:09:08 CEST)

How to cite: Marchegiani, F.; Galeazzi, R.; Moroni, F.; Appolloni, S.; Cherubini, A.; Salvi, F.; Cecchini, S.; Paci, E.; Evangelisti, A.; Olivieri, F.; Sabbatinelli, J.; Procopio, A. D. Age‐Related Reduction of D‐Dimer Cut‐Off Level Specificity: Diagnostic Relevance in Geriatric Patients. Preprints 2024, 2024051252. https://doi.org/10.20944/preprints202405.1252.v1 Marchegiani, F.; Galeazzi, R.; Moroni, F.; Appolloni, S.; Cherubini, A.; Salvi, F.; Cecchini, S.; Paci, E.; Evangelisti, A.; Olivieri, F.; Sabbatinelli, J.; Procopio, A. D. Age‐Related Reduction of D‐Dimer Cut‐Off Level Specificity: Diagnostic Relevance in Geriatric Patients. Preprints 2024, 2024051252. https://doi.org/10.20944/preprints202405.1252.v1

Abstract

D-dimer testing in combination with clinical assessment is commonly used to diagnose suspected DVT and pulmonary embolism. However, as D-dimer levels are physiologically higher in elderly patients, this test loses clinical specificity in the setting of geriatric patients. The aim of our study was to investigate the changes in D-dimer levels with age and the specificity of the D-dimer test in the diagnosis of pulmonary embolism. 1617 elderly patients consecutively admitted to the Geriatric Emergency Care Department of the INRCA-IRCCS hospital between January 2013 and February 2014 and for whom D-dimer results were available were included. The D-dimer immunoturbidimetric assay was performed on a cs-2100i Sysmex Siemens using a conventional cut-off level of 500 µg/L. The median D-dimer level was 1200 [550-2990] µg/L FEU, and the percentage of patients with D-dimer levels below the conventional cut-off was only 22.1%. As expected, there was a significant age-related increase in D-dimer, even when sex was considered, and a significant decrease in the specificity of D-dimer assay with age. The most established use of D-dimer testing is in the diagnosis of deep vein thrombosis or pulmonary embolism. Our study confirms the need for an age-adjusted cut-off for D-dimer testing in geriatric patients.

Keywords

D‐dimer; pulmonary embolism; specificity; aging

Subject

Medicine and Pharmacology, Clinical Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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