Age-adjusted D-dimer

D-dimer rises with age, so the fixed 500 µg/L cut-off excludes PE in few older patients. In patients with low or intermediate (PE unlikely) clinical probability, a cut-off of age × 10 µg/L over 50 years safely excluded PE in many more of them (ADJUST-PE: 29.7% vs 6.4% of patients aged ≥ 75). ESC 2019 recommends it as an alternative to the fixed cut-off (Class IIa).

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Clinical probability

Wells ≤ 4 (PE unlikely) or Geneva low/intermediate

Patient

Age

years

D-dimer

µg/L FEU

µg/L = ng/mL; mg/L = µg/mL. DDU assays: roughly double the value to get FEU.

Age-adjusted D-dimer cut-off

Enter the age.

References

Righini M, et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study. JAMA 2014;311:1117-1124.
Konstantinides SV, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism. Eur Heart J 2020;41:543-603.