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

Abstract

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.

Evaluation of Anticoagulant Proteins and Fibrinolytic System Markers in Children with Pneumonia

“…Recent studies support that intravascular and extravascular coagulation show a relationship with acute and chronic lung injury (9,10). Enzymatic degradation of fibrin by the fibrinolytic system may cause FDPs, such as DD, to be released into the circulation (8,9,11). Also, plasma DD levels may increase as a result of the activation of the blood coagulation process; which is caused by endotoxins in the gramnegative pathogens that trigger CAP (12).…”

Incidence of Pulmonary Embolism in Patients with Positive D-Dimers and Chest X-ray Evidence of Pneumonia: A Retrospective Study

“…More recent studies focusing on D-dimer in pneumonia have attempted to use it as a risk-stratification tool, with some success [7][8][9]. However, these studies investigated patients already carrying the diagnosis of community-acquired pneumonia.…”

“…They compared negative D-dimer to CURB-65 and Pneumonia Severity Index, finding that it was comparable and may identify some patients as low risk that the other models would identify as higher risk (these patients did well) [10,11]. Arslan S et al evaluated 60 patients diagnosed with lobar or multi-lobar pneumonia, also finding that D-dimer increased with severity of illness, as well as in the presence of co-morbid conditions [9].…”

Evaluation of Serum D-dimer Levels in Children with Pneumonia

“…Fibrinolitik sistemin aktivasyonu ile alveol boşlukları içerisinde biriken fibrinin yıkıldığı ve fibrin yıkım ürünü olan D-dimerin serumda yükseldiği bildirilmiştir (5,7). Ayrıca pnömonili olgularda mikroorganizmaların bakteri duvarı fragmanlarının ya da gram negatif olanların endotoksinlerinin de fibrinolitik sistemin aktivasyonunu tetiklediği düşünülmektedir (7). Literatürde erişkin pnömonili olgularda D-dimer düzeylerini araştıran sınırlı sayıda çalışmaya rastlanırken bizim bilgilerimize göre çocuklarda yapılmış hiçbir çalışma yoktur.…”