Age-Adjusted D-Dimer Cutoff in Ruling Out Pulmonary Embolism among Saudi Arabians in Riyadh Province

Abstract

Objective. The study aimed to investigate the effectiveness of an age-adjusted D-dimer (AADD) cutoff in ruling out pulmonary embolism (PE) among the Saudi population, addressing the lack of data on AADD utility in this demographic. Methods. This single-centre retrospective cohort study conducted at Department of Medicine, King Abdulaziz Medical City in Riyadh, Saudi Arabia, between 2010 and 2018 analysed the data from patients suspected of PE who underwent computed tomography pulmonary angiography (CTPA). Age-adjusted D-dimer (AADD) levels were calculated for patients over 50 years of age [(age×10) µg/L], and AADD cutoffs were compared for diagnostic accuracy. Results. Among 277 subjects meeting inclusion criteria, a significant association between D-dimer levels and PE presence was observed. The AADD criteria showed a specificity of 94.7% and a sensitivity of 25%, with a Youden index of 0.2. The high negative predictive value of 90.62% supported the use of AADD in confirming the absence of PE in patients. Conclusions. Based on the study findings, the AADD cutoff [(age×10) µg/L] can be efficiently and safely used as an exclusionary tool for patients over 50 years of age suspected of having PE. This study supports the clinical utility of AADD, particularly in older Saudi patient populations.