Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis

Background: Pulmonary embolism (PE), depending on the severity, carries a high mortality and morbidity. Proper evaluation, especially in patients with low probability for PE, is important to avoid unnecessary diagnostic testing. Objective: To review the diagnostic utility of conventional versus age-...

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Autores principales:	Kenneth Iwuji, Hasan Almekdash, Kenneth M. Nugent, Ebtesam Islam, Briget Hyde, Jonathan Kopel, Adaugo Opiegbe, Duke Appiah
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Computer applications to medicine. Medical informatics R858-859.7 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/bd0fe943c89c4ff79f34230d579621c6
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spelling	oai:doaj.org-article:bd0fe943c89c4ff79f34230d579621c62021-12-01T23:06:59ZAge-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis2150-132710.1177/21501327211054996https://doaj.org/article/bd0fe943c89c4ff79f34230d579621c62021-11-01T00:00:00Zhttps://doi.org/10.1177/21501327211054996https://doaj.org/toc/2150-1327Background: Pulmonary embolism (PE), depending on the severity, carries a high mortality and morbidity. Proper evaluation, especially in patients with low probability for PE, is important to avoid unnecessary diagnostic testing. Objective: To review the diagnostic utility of conventional versus age-adjusted D-dimer cutoff values in patients 50 years and older with suspected pulmonary embolism. Methods: Systematic review with univariant and bivariant meta-analysis. Data sources: We searched PubMed, MEDLINE, and EBSCO for studies published before September 20th, 2020. We cross checked the reference list of relevant studies that compares conventional versus age-adjusted D-dimer cutoff values in patients with suspected pulmonary embolism. Study selection: We included primary published studies that compared both conventional (500 µg/L) and age-adjusted (age × 10 µg/L) cutoff values in patients with non-high clinical probability for pulmonary embolism. Results: Nine cohorts that included 47 720 patients with non-high clinical probability were included in the meta-analysis. Both Age-adjusted D-dimer and conventional D-dimer have high sensitivity. However, conventional D-dimer has higher false positive rate than age-adjusted D-dimer. Conclusion: Age-adjusted D-dimer cutoffs combined with low risk clinical probability assessment ruled out PE diagnosis in suspected patients with a decreased rate of false positive tests.Kenneth IwujiHasan AlmekdashKenneth M. NugentEbtesam IslamBriget HydeJonathan KopelAdaugo OpiegbeDuke AppiahSAGE PublishingarticleComputer applications to medicine. Medical informaticsR858-859.7Public aspects of medicineRA1-1270ENJournal of Primary Care & Community Health, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Computer applications to medicine. Medical informatics R858-859.7 Public aspects of medicine RA1-1270
spellingShingle	Computer applications to medicine. Medical informatics R858-859.7 Public aspects of medicine RA1-1270 Kenneth Iwuji Hasan Almekdash Kenneth M. Nugent Ebtesam Islam Briget Hyde Jonathan Kopel Adaugo Opiegbe Duke Appiah Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis
description	Background: Pulmonary embolism (PE), depending on the severity, carries a high mortality and morbidity. Proper evaluation, especially in patients with low probability for PE, is important to avoid unnecessary diagnostic testing. Objective: To review the diagnostic utility of conventional versus age-adjusted D-dimer cutoff values in patients 50 years and older with suspected pulmonary embolism. Methods: Systematic review with univariant and bivariant meta-analysis. Data sources: We searched PubMed, MEDLINE, and EBSCO for studies published before September 20th, 2020. We cross checked the reference list of relevant studies that compares conventional versus age-adjusted D-dimer cutoff values in patients with suspected pulmonary embolism. Study selection: We included primary published studies that compared both conventional (500 µg/L) and age-adjusted (age × 10 µg/L) cutoff values in patients with non-high clinical probability for pulmonary embolism. Results: Nine cohorts that included 47 720 patients with non-high clinical probability were included in the meta-analysis. Both Age-adjusted D-dimer and conventional D-dimer have high sensitivity. However, conventional D-dimer has higher false positive rate than age-adjusted D-dimer. Conclusion: Age-adjusted D-dimer cutoffs combined with low risk clinical probability assessment ruled out PE diagnosis in suspected patients with a decreased rate of false positive tests.
format	article
author	Kenneth Iwuji Hasan Almekdash Kenneth M. Nugent Ebtesam Islam Briget Hyde Jonathan Kopel Adaugo Opiegbe Duke Appiah
author_facet	Kenneth Iwuji Hasan Almekdash Kenneth M. Nugent Ebtesam Islam Briget Hyde Jonathan Kopel Adaugo Opiegbe Duke Appiah
author_sort	Kenneth Iwuji
title	Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis
title_short	Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis
title_full	Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis
title_fullStr	Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis
title_full_unstemmed	Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis
title_sort	age-adjusted d-dimer in the prediction of pulmonary embolism: systematic review and meta-analysis
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/bd0fe943c89c4ff79f34230d579621c6
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Age-Adjusted D-Dimer in the Prediction of Pulmonary Embolism: Systematic Review and Meta-analysis

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