文章基本信息

标题：Clinical applicability of D-dimer assay in the diagnosis of pulmonary embolism reduces with aging
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作者：Luca Masotti ; Giancarlo Landini ; Fabio Antonelli 等
期刊名称：Clinical Management Issues
印刷版ISSN：2283-3137
出版年度：2007
卷号：1
期号：4
页码：153-164
DOI：10.7175/cmi.v1i4.597
语种：Italian
出版社：SEEd
摘要：Despite modern algorithms have been proposed for diagnosis of pulmonary embolism (PE), it remains understimed and often missed in clinical practice, especially in elderly patients, resulting in high morbidity and mortality when early and correctly untreated. One of the main controversial issue is represented by the role and applicability of D-dimer in the diagnostic work up of geriatric patients. Most recent guidelines in young-adult patients suggest to perform D-dimer assay by ELISA or immunoturbidimetric methods only in non high pre-test clinical probability (PTP) patients; in these patients negative D-dimer can safely rule out the diagnosis of PE. This strategy is safe also in elderly patients; however the percentage of patients with non high PTP and negative D-dimer reduces progressively with age, making difficult its clinical applicability. The Authors, starting from two case reports, up date the diagnostic management of PE underling the limitations of D-dimer assay in elderly patients.
关键词：D-dimer;Clinical probability;Pulmonary embolism;Diagnosis;Elderly