Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: The use of age-related D-dimers to rule out deep vein thrombosis.

A short cut review was carried out to establish whether the use of age-adjusted D-dimer cut-offs is better than the standard, unadjusted diagnostic cut-off for excluding the diagnosis of deep vein thrombosis (DVT) in the Emergency Department. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that the use of an age-adjusted D-dimer cut-off in patients aged over 50 years increases the ability to safely exclude DVT in patients with low clinical probability without the need for ultrasound scanning.