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Effect of using an age‐adjusted D‐dimer to assess for pulmonary embolism in community emergency departments

Academic Emergency Medicine Nov 21, 2020

Ghobadi A, Lin B, Musigdilok VV, et al. - Researchers assessed how changing the laboratory reported D‐dimer thresholds to age‐adjusted standards can impact the use of advanced chest imaging and 30‐day adverse events in emergency department (ED) encounters. In this retrospective interrupted time series analysis, ED encounters for patients > 50 years assessed for suspected PE from April 2014‐April 2016 were analyzed. Use of advanced diagnostic imaging was the primary outcome, and 30‐day death or PE diagnosis was the secondary outcome. Delayed PE diagnoses before and after intervention were quantified in secondary analyses. According to the findings, no decrease in advanced chest imaging as well as no rise in 30‐day adverse events was noted in relation to changing the laboratory reported D‐dimer thresholds for evaluation of PE. However, in the post‐intervention period, substantial non‐compliance with the age‐adjusted standards was observed, likely blunting the effect of this intervention.

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