Age-Adjusted D-Dimer in Ruling Out Acute Aortic Syndrome
Background. Recently, D-dimer has been suggested as a biomarker to rule out acute aortic syndrome (AAS). Since it increases with age, this study was conducted to reveal whether an age-adjusted D-dimer can increase diagnostic accuracy in ruling out AAS. Method. A retrospective observational study des...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2022/6864756 |
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| author | Dayeon Lee Yong Won Kim Tae Youn Kim Sanghun Lee Han Ho Do Jun Seok Seo Jeong Hun Lee |
| author_facet | Dayeon Lee Yong Won Kim Tae Youn Kim Sanghun Lee Han Ho Do Jun Seok Seo Jeong Hun Lee |
| author_sort | Dayeon Lee |
| collection | DOAJ |
| description | Background. Recently, D-dimer has been suggested as a biomarker to rule out acute aortic syndrome (AAS). Since it increases with age, this study was conducted to reveal whether an age-adjusted D-dimer can increase diagnostic accuracy in ruling out AAS. Method. A retrospective observational study design was used. Consecutive adult patients who visited an emergency room between January 2015 and September 2020 and who underwent a D-dimer test and computed tomography angiography for suspected AAS were enrolled. We calculated the diagnostic accuracy of both the conventional (0.5 μg/ml) and age-adjusted (age × 0.01 in patients >50 years) D-dimer cut-offs. Result. D-dimer was higher in the AAS group (n = 82) than in the non-AAS group (n = 122) (10.85 (3.61–33.12) vs. 0.40 (0.23–1.07), OR: 1.139 (CI: 1.085 – 1.195), p<0.001). The D-dimer plasma level had an area under the ROC curve of 0.915 (CI: 0.873–0.956) with AAS. At the age-adjusted cutoff point compared to a 0.5 μg/ml cutoff, the sensitivity of 97.6% and the NLR of 0.04 did not change, but the specificity increased by 5.7% to 65.6%, the PPV increased by 3.6% to 65.6%, and the NPV slightly increased by 0.2% to 97.6%. Conclusion. Compared with a conventional method, the age-adjusted D-dimer cutoff may have higher specificity and PPV while maintaining high sensitivity for ruling out AAS. |
| format | Article |
| id | doaj-art-0bea503db52a412d98068a4ebac98eb8 |
| institution | Kabale University |
| issn | 2090-2859 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-0bea503db52a412d98068a4ebac98eb82025-02-03T01:00:46ZengWileyEmergency Medicine International2090-28592022-01-01202210.1155/2022/6864756Age-Adjusted D-Dimer in Ruling Out Acute Aortic SyndromeDayeon Lee0Yong Won Kim1Tae Youn Kim2Sanghun Lee3Han Ho Do4Jun Seok Seo5Jeong Hun Lee6Department of Emergency MedicineDepartment of Emergency MedicineDepartment of Emergency MedicineDepartment of Emergency MedicineDepartment of Emergency MedicineDepartment of Emergency MedicineDepartment of Emergency MedicineBackground. Recently, D-dimer has been suggested as a biomarker to rule out acute aortic syndrome (AAS). Since it increases with age, this study was conducted to reveal whether an age-adjusted D-dimer can increase diagnostic accuracy in ruling out AAS. Method. A retrospective observational study design was used. Consecutive adult patients who visited an emergency room between January 2015 and September 2020 and who underwent a D-dimer test and computed tomography angiography for suspected AAS were enrolled. We calculated the diagnostic accuracy of both the conventional (0.5 μg/ml) and age-adjusted (age × 0.01 in patients >50 years) D-dimer cut-offs. Result. D-dimer was higher in the AAS group (n = 82) than in the non-AAS group (n = 122) (10.85 (3.61–33.12) vs. 0.40 (0.23–1.07), OR: 1.139 (CI: 1.085 – 1.195), p<0.001). The D-dimer plasma level had an area under the ROC curve of 0.915 (CI: 0.873–0.956) with AAS. At the age-adjusted cutoff point compared to a 0.5 μg/ml cutoff, the sensitivity of 97.6% and the NLR of 0.04 did not change, but the specificity increased by 5.7% to 65.6%, the PPV increased by 3.6% to 65.6%, and the NPV slightly increased by 0.2% to 97.6%. Conclusion. Compared with a conventional method, the age-adjusted D-dimer cutoff may have higher specificity and PPV while maintaining high sensitivity for ruling out AAS.http://dx.doi.org/10.1155/2022/6864756 |
| spellingShingle | Dayeon Lee Yong Won Kim Tae Youn Kim Sanghun Lee Han Ho Do Jun Seok Seo Jeong Hun Lee Age-Adjusted D-Dimer in Ruling Out Acute Aortic Syndrome Emergency Medicine International |
| title | Age-Adjusted D-Dimer in Ruling Out Acute Aortic Syndrome |
| title_full | Age-Adjusted D-Dimer in Ruling Out Acute Aortic Syndrome |
| title_fullStr | Age-Adjusted D-Dimer in Ruling Out Acute Aortic Syndrome |
| title_full_unstemmed | Age-Adjusted D-Dimer in Ruling Out Acute Aortic Syndrome |
| title_short | Age-Adjusted D-Dimer in Ruling Out Acute Aortic Syndrome |
| title_sort | age adjusted d dimer in ruling out acute aortic syndrome |
| url | http://dx.doi.org/10.1155/2022/6864756 |
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