Abstract:
:Pulmonary embolism (PE) is a potentially severe diagnosis with high short-term mortality. Recently, age-adjusted cut-off values (age × 10 μg/l) of D-dimer were introduced to improve the diagnostic workup in older patients. In clinical practice, PE is considered 'ruled out' in patients with a non-high clinical probability and a normal D-dimer. However, all diagnostic tests have a small false-negative rate. This small probability of misdiagnosis might be easily overlooked by clinicians when using simplified dichotomized flow charts. This case illustrates a normal D-dimer (age-adjusted) but with a PE. We recommend clinicians using the D-dimer test-either conventional or age-adjusted in a rule-out strategy to be aware of the-albeit small probability of a false-negative result.
journal_name
Age Ageingjournal_title
Age and ageingauthors
Stein CE,Keijsers CJ,Bootsma JE,Schouten HJdoi
10.1093/ageing/afw132subject
Has Abstractpub_date
2016-11-01 00:00:00pages
910-911issue
6eissn
0002-0729issn
1468-2834pii
afw132journal_volume
45pub_type
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