Age- and sex-dependent reference intervals for D-dimer: Evidence for a marked increase by age

作者：Haase Christine; Joergensen Maja; Ellervik Christina; Joergensen Mikala Klok; Bathum Lise^*

来源：Thrombosis Research, 2013, 132(6): 676-680.

DOI：10.1016/j.thromres.2013.09.033

• D-dimer
• Venous thromboembolism
• Reference intervals

Introduction: A low D-dimer is commonly used to exclude venous thromboembolism in low risk patients. However, the reference intervals are poorly defined and D-dimer has been shown to increase by patient age. We aimed to establish age-and sex-dependent D-dimer reference intervals and to test the consequence of different cut-off limits. %26lt;br%26gt;Materials and methods: By means of the STA-Lia test D-dimer was measured in 1,352 subjects aged between 23 and 93 years from the general population. A further 94 subjects were measured with the HemosIL test. %26lt;br%26gt;Results: The reference intervals were age-dependent with the upper 95% limit increasing from 0.92 FEU mg/L in the age group %26lt;50 years to 2.39 FEU mg/L in the group %26gt;= 70 years. Minor differences in the reference intervals between sexes were found. The commonly used cut-off at 0.5 FEU mg/L resulted in a decrease of negatives from 91% in %26lt;50 years to 56 % in %26gt;= 70 years. The age-dependent cut-off value (patient%26apos;s age*0.01 FEU mg/L in 50+years) resulted in an increase of negatives by age. The linear increase in D-dimer has a slope at approximately 0.0077*age, meaning that a cut-off at (patient%26apos;s age*0.0077) FEUmg/L, gives an almost constant number of positives across age groups. %26lt;br%26gt;The two assays showed a poor correlation and a higher percentage of positives using the STA Lia test. %26lt;br%26gt;Conclusions: The age-dependent increase in D-dimer seen in patients was confirmed, which questions the clinical value of the present cut-off for venous thromboembolism.

• 出版日期2013-12