Does the PaDd (Padua score × D-dimer) composite improve the specificity of pulmonary embolism exclusion without compromising safety in adults aged ≥65 years?
The PaDd composite (Padua score × D-dimer) represents a promising, hypothesis-generating strategy to improve the specificity of pulmonary embolism exclusion in older adults.
To the Editor: We commend Cohen et al. for introducing a prag-matic composite—Padua score × D-dimer (PaDd)—designed to refine pulmonary embolism (PE) exclusion in adults aged ≥65 years, a population often characterized by multimorbidity, physiological heterogeneity, and atypical presentations. Their single-center retrospective cohort (2021–2023) provides a compelling, hypothesis-generating signal: combining a validated venous thromboembolism risk score with D-dimer may enhance specificity without compromising safety.
Vijayasimha et al. (Wed,) studied this question.