D-dimer assay predicts mortality in critically ill patients without disseminated intravascular coagulation or venous thromboembolic disease

Shorr, Andrew F.; Trotta, R; Alkins, Stephan A.; Hanzel, George; Diehl, Louis F.

doi:10.1007/s001340050817

Cited by 64 publications

(11 citation statements)

References 10 publications

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“…Our results corroborated with those of previous studies [21,22]. Furthermore, D-Dimer has been previously shown to a sensitive independent predictor of mortality among ICU patients [23], which was corroborated by our results. We observed that, compared to the discharge group, significantly higher proportion of patients in the death group exhibited D-Dimer > 1200 ng/mL (P = 0.023).…”

Section: Discussionsupporting

confidence: 93%

Assessment of clinical characteristics and mortality-associated factors in COVID-19 Critical cases in Kuwait

Ayed

Borahmah

Yazdani

et al. 2020

Preprint

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Purpose To assess the clinical characteristics and identify mortality predicting factors in intensive care unit (ICU)-admitted COVID-19 confirmed patients. Methods We recruited and analyzed COVID-19 infected adult patients (age≥ 18 years) who were admitted to the ICU at Jaber AlAhmad Al Sabah Hospital,Kuwait, between 1st March, 2020and 30th April 2020. The patients were followed up to 20th May, 2020. The risk factors associated with in-hospital mortality were assessed using multiple regression analysis. Results We recruited a total of 103 ICU patients in this retrospective cohort. The median age of the patients was 53 years (Interquartile Range (IQR): 44-63 years). The fatality rate was 43.7%. Among the patients, majority were males (85.5%) and 38% patients had more than two comorbidities. Pre-existing hypertension (OR:3.2,95%CI: 1.2-8.9), moderate/severe ARDS (OR: 3.4, 95%CI: 1.1-10.8),lymphocyte counts <0.5 (OR: 6.1, 95%CI: 1.2-29.8) albumin < 22 (OR: 7.5, 95%CI: 2.1-26.2), procalcitonin >0.2 (OR: 3.8, 95%CI: 1.3-7.8), D-Dimer >1200 (OR: 5.1, 95%CI: 1.2-21.6), and the need for continuous renal replacement therapy (OR: 9.3, 95%CI: 2.4-36.2) were significantly associated with mortality. Conclusion This study describes the clinical characteristics and predictors of mortality among ICU patients. Early identification of risk factors to mortality might help in their better outcome.

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Section: Discussionsupporting

confidence: 93%

Assessment of clinical characteristics and mortality-associated factors in COVID-19 Critical cases in Kuwait

Ayed

Borahmah

Yazdani

et al. 2020

Preprint

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“…They also determined that CAP patients in PSI classes IV and V who had plasma DD levels higher than 2000 ng/mL had a higher risk of mortality 18. Some researchers have suggested that increased plasma DD levels are related to the extent of pneumonia because the PSI and APACHE II score are closely associated with the mortality rate 21. Low plasma DD levels in CAP patients (less than 500 ng/mL) at the time of admission to the hospital has been linked to a decreased likelihood of an early death or major morbidity 19.…”

Section: Discussionmentioning

confidence: 99%

The Association between Plasma D-dimer Levels and Community-Acquired Pneumonia

Arslan

Uğurlu

Bulut

et al. 2010

Clinics

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BACKGROUND:Plasma D-dimer levels are directly related to the intra- and extra-vascular coagulation that occurs in acute and chronic lung damage in patients with community-acquired pneumonia (CAP).OBJECTIVES:This study examines the relationship between the severity of community-acquired pneumonia and D-dimer levels. In addition, the study examines the correlations among community-acquired pneumonia, the radiological extent of the disease and mortality.METHODS:The Pneumonia Severity Index was used to classify patients into five groups. Patients were treated at home or in the hospital according to the guidelines for community-acquired pneumonia. Blood samples were taken from the antecubital vein with an injector and placed into citrated tubes. After they were centrifuged, the samples were evaluated with the quantitative latex method.RESULTS:The study included 60 patients who had been diagnosed with community-acquired pneumonia (mean age 62.5 ± 11.7) and 24 healthy controls (mean age 59.63 ± 6.63). The average plasma D-dimer levels were 337.3 ± 195.1ng/mL in the outpatient treatment group, 691.0 ± 180.5 in the inpatient treatment group, 1363.2 ± 331.5 ng/mLin the intensive care treatment group and 161.3 ± 38.1ng/mL in the control group (p<0.001). The mean D-dimer plasma level was 776.1 ± 473.5ng/mL in patients with an accompanying disease and 494.2 ± 280.1 ng/mL in patients without an accompanying disease (p<0.05).CONCLUSIONS:Plasma D-dimer levels were increased even in community-acquired pneumonia patients who did not have an accompanying disease that would normally cause such an increase.

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“…At the same time, prothrombin activation and fibrin deposition can stimulate the extrinsic coagulation system and render the patient's blood hypercoagulable. D-Dimer is a stable and specific degradation product of cross-linked fibrin, and its increased level indicates enhanced secondary fibrinolytic activity, which can be used as one of the molecular markers of hypercoagulability and hyperfibrinolysis in vivo (34). In particular, D-dimer has been found to be well correlated with the disease activity of HSP (35).…”

Section: Discussionmentioning

confidence: 99%

Analysis of 135 Cases of Pediatric Henoch-Schönlein Purpura in Gansu, Northwestern China

et al. 2019

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Background: Henoch-Schönlein purpura (HSP) is the most widespread systemic small-vessel vasculitis of childhood. Limited information exists about the epidemiology, allergen and laboratory bio-markers reflecting HSP disease phases in Northwestern China. Objectives: To comprehensively evaluate the epidemiology, allergen and laboratory bio-markers reflecting HSP disease phases for the first time in this region. Methods: We retrospectively evaluated 135 HSP patients and 86 controls aged ≤ 14 years admitted to the Children's Hospital of Gansu Province between January 2016 and December 2017. Epidemiological profiles, clinical characteristics and laboratory biomarkers of both inflammation and activated coagulation were analyzed for each HSP patients and controls. The monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated based upon the results of routine blood tests performed during hospital stay of the patients. Results: In total, 77 patients had arthritis, 46 had gastrointestinal involvement and 15 had renal involvement. The most common predisposing factors were upper and lower respiratory tract infections, allergies and seasonal variation. Frequency of renal involvement was significantly higher among patients older than 7 years but lower with a positive rate of allergens. The average levels of Creactive protein, white blood cells (WBC), neutrophils, platelets, D-dimer, fibrin degradation product (FDP), NLR and PLR among patients were significantly increased compared with the control group. Sensitivity and specificity were highest for neutrophil counts, while the area under the curve (AUC) for platelet count was highest. Patients with gastrointestinal involvement had significantly higher WBC, neutrophil count, D-dimer and FDP levels than those without. Sensitivity, specificity and AUC were highest for neutrophil counts. Increased D-dimer levels were significantly associated with gastrointestinal involvement and renal involvement. Conclusions: The first report of epidemiologic characteristics of HSP in children in this area enriches the HSP epidemiological data of China. Exposure to allergens should be reduced in patients aged approximately 7 years and renal involvement should be carefully monitored in patients aged > 7 years. WBC count, neutrophil, D-dimer and FDP levels are better than conventional infection markers. Particularly, D-dimer is an independent predictor on HSP patients with gastrointestinal involvement and renal involvement.

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D-dimer assay predicts mortality in critically ill patients without disseminated intravascular coagulation or venous thromboembolic disease

Cited by 64 publications

References 10 publications

Assessment of clinical characteristics and mortality-associated factors in COVID-19 Critical cases in Kuwait

Assessment of clinical characteristics and mortality-associated factors in COVID-19 Critical cases in Kuwait

The Association between Plasma D-dimer Levels and Community-Acquired Pneumonia

Analysis of 135 Cases of Pediatric Henoch-Schönlein Purpura in Gansu, Northwestern China

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