Age-Adjusted D-dimer (ADJUST-PE)
ADJUST-PE (Righini 2014); endorsed by ESC 2019 PE guidelineCompares a measured D-dimer against the conventional 500 ng/mL FEU cutoff or, for patients over 50, the age-adjusted cutoff (age x 10 ng/mL FEU), with automatic FEU/DDU unit conversion.
Also searched as: pulmonary embolism · DVT · rule-out · FEU · DDU · thrombosis
Information
Incomplete input
- Please provide: age, D-dimer value, assay units (FEU or DDU).
How this tool works
D-dimer specificity falls steadily with age, so the ADJUST-PE study prospectively validated a higher cutoff of age x 10 ng/mL FEU for patients older than 50, keeping 500 ng/mL FEU for younger patients. Results reported in D-dimer units (DDU) are converted to fibrinogen-equivalent units (FEU) using the standard factor of two, so the conventional cutoff equals 250 ng/mL DDU. A value below the applicable cutoff excludes PE (or DVT) in patients with a low or intermediate pre-test probability; a value at or above it is positive and mandates imaging. The rule must not be used when the pre-test probability is high.
References
- Righini M, et al. ADJUST-PE. JAMA 2014;311:1117-1124
- 2019 ESC Guidelines, acute pulmonary embolism. Eur Heart J 2020;41:543-603
Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.
Clinical questions that use this
Vetting guides that reach for this tool.
Related calculators
Same subspecialty, overlapping subject matter.