Righini et al reported an algorithm for evaluating a patient with suspected pulmonary embolism (PE). This uses an age-adjusted cut-off for plasma D-dimer levels to triage the patient. The authors are from multiple institutions in Europe and Canada.
Patient selection: suspected pulmonary embolism
Parameters:
(1) age in years
(2) Wells score (simple clinical score, from 0 to 12.5)
(3) plasma D-Dimer in ng/mL
Age in Years
Wells Score
D-Dimer
Outcome
< 50 years
<= 4
< 500 ng/mL
PE excluded
< 50 years
<= 4
>= 500 ng/mL
order CTPA
< 50 years
> 4
NA
order CTPA
>= 50 years
<= 4
< (age) *10
PE excluded
>= 50 years
<= 4
>= (age) * 10
order CTPA
>= 50 years
> 4
NA
order CTPA
where:
• CTPA is CT pulmonary angiography.
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