Authors:	Prochaska, Jürgen H. Frank, Bernd Nagler, Markus Lamparter, Heidrun Weißer, Gerhard Schulz, Andreas Eggebrecht, Lisa Göbel, Sebastian Arnold, Natalie Panova-Noeva, Marina Hermanns, Iris Pinto, Antonio Konstantinides, Stavros ten Cate, Hugo Lackner, Karl J. Münzel, Thomas Espinola-Klein, Christine Wild, Philipp
Title:	Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis
Online publication date:	13-Jun-2022
Year of first publication:	2017
Language:	english
Abstract:	Previous reports have investigated the impact of age on D-Dimer testing in elderly individuals with suspected deep vein thrombosis (DVT), but data on the age-related diagnostic value of D-dimer in a sample covering a broad age range are limited. The present study determined age-specifically the diagnostic accuracy of D-dimer and compared it to C-reactive protein (CRP), a marker of inflammation, in 500 patients with suspected DVT from the VTEval project (NCT02156401). Sensitivity of D-dimer was lower in patients < 60 years in comparison to patients ≥ 60 years (∆−16.8%), whereas specificity was 27.9% higher. Lowest levels of sensitivity were detected for female sex, unprovoked DVT, low thrombotic burden, and distal DVT. A fixed D-dimer threshold of 0.25 mg/L FEU resulted in elevated sensitivity for patients < 60 with a reduction of false negatives by 40.0% for proximal DVT and by 50.0% for distal DVT. In patients < 60 years, D-dimer and CRP demonstrated comparable diagnostic performance for both proximal and distal DVT (p > 0.05). In conclusion, these data outline a clinically-relevant limitation of D-dimer testing among younger patients with suspected DVT indicating a necessity for age-adapted cut-off values. Further research is required to decrypt the role of inflammation in the pathophysiology and diagnosis of venous thrombosis.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-7123
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Scientific reports 7
Pages or article number:	Art. 4591
Publisher:	Macmillan Publishers Limited, part of Springer Nature
Publisher place:	London
Issue date:	2017
ISSN:	2045-2322
Publisher URL:	http://dx.doi.org/10.1038/s41598-017-04843-x
Publisher DOI:	10.1038/s41598-017-04843-x
Appears in collections:	DFG-OA-Publizieren (2012 - 2017)