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Age-Adjusted D-dimer Cutoff for Pulmonary Embolism

In patients older than 50 with non-high (or "PE unlikely") clinical probability, the D-dimer cutoff for excluding PE is age × 10 µg/L FEU (ng/mL) instead of the fixed 500 µg/L. A D-dimer below the age-adjusted cutoff rules out PE without imaging (ADJUST-PE 3-month failure rate 0.3%).

Age (years)
D-dimer (FEU) (ng/mL or µg/L or mg/L)

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Interpretation

Result	Meaning
Age ≤ 50	Cutoff 500 µg/L (ng/mL) FEU
Age > 50	Cutoff = age × 10 µg/L FEU
D-dimer < cutoff	PE excluded (only if clinical probability non-high / PE unlikely)

Formula

Cutoff (µg/L FEU) = age × 10 if age > 50, otherwise 500. 1 mg/L FEU = 1000 µg/L = 1000 ng/mL.

Clinical pearls

Only valid after a non-high clinical probability (Wells ≤4 / "PE unlikely", or Geneva non-high); high-probability patients go straight to imaging.
The rule assumes an FEU-reported assay. If your lab reports D-dimer units (DDU), 1 DDU ≈ 0.5 FEU, so the DDU cutoff is about age × 5.
ADJUST-PE validated the rule in emergency outpatients; evidence in inpatients, pregnancy and cancer is weaker.

Examples

age adjusted d-dimer 78 yo, d dimer 690 age-adjusted d-dimer: is 0.72 mg/L negative for a 76 year old age-adjusted ddimer cutoff for 64 year old

FAQ

What is the age-adjusted D-dimer cutoff?

Age × 10 µg/L (ng/mL) FEU for patients over 50, e.g. 750 for a 75-year-old; 500 for anyone 50 or younger.

Can I use age-adjusted D-dimer for DVT?

It has been studied for DVT too, but ADJUST-PE validated it for suspected PE with non-high clinical probability.

Evidence

Righini M et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study. JAMA 2014;311:1117–24.

Cardiology · Reviewed 2026-10-14 · Methodology