Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients

Ichkawa, Yuhuko; Wada, Hideo; Ezaki, Minoru; Tanaka, Motoko; Hiromori, Shinya; Shiraki, Katsuya; Moritani, Isao; Yamamoto, Akira; Tashiro, Haruhiko; Shimpo, Hideto; Shimaoka, Motomu

doi:10.1177/1076029620973084

Cited by 16 publications

(21 citation statements)

References 27 publications

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“…The studies in the literature show that D-dimer levels can be related to many diseases and it can be used in the prognosis (14)(15)(16)(17)(18)(19)(20). The thrombotic incidents that occur in COPD are explained by carbon dioxide retention and hypercoagulation (11,21,22).…”

Section: Discussionmentioning

confidence: 99%

The effects of D-dimer high rates on prognosis and mortality in chronic obstructive respiratory disease

SAYMAZ

Çelik²,

Yıldız

et al. 2022

Anatolian Current Medical Journal

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Aim:We aim to answer the question of "Can D-dimer be an indicator of prognosis and mortality in COPD exacerbations?" by doing retrospective research on the prognosis and mortality of patients who had high D-dimer levels in COPD exacerbations with no thromboembolism detected. Material and Method: Our research is retrospective and cross-sectional. A total of 115 patients who had applied to our hospital between January 2018 and January 2019 with COPD acute exacerbations and who had higher D-dimer levels detected than the 0.44 mg/L upper limit of our hospital's laboratory are included in this research. All patients have been previously diagnosed with COPD by a pulmonologist and have been undergoing treatment. Patients under the age of 18, patients whose information was not accessible through their files, pregnant patients, patients who have not been diagnosed with COPD by a pulmonologist, patients who had been diagnosed with lung malignancy through pathology, patients where pulmonary embolism was detected through pulmonary CT angiography, patients with renal function test disorder and patients with known renal failure are not included in this study. Results: A total of 115 patients were included in the study. Patients who developed mortality had statistically significant lower levels of OSAS, higher rates of pneumonia, anemia, and liver failure, higher numbers of applications to emergency services in 1 year, higher numbers of hospitalizations due to COPD acute exacerbations in 1 year, higher numbers of intensive care unit admissions due to COPD acute exacerbations in 1 year and lower survival time. In addition, patients who developed mortality had statistically significant lower rates of group B and C and higher rates of group D according to the classification of Global Initiative of Chronic Obstructive Lung Disease (GOLD). Although the D-dimer levels were higher in patients who developed mortality, there were no statistically significant differences between groups. No significant cut-off value for D-dimer was calculated. Conclusion: As a result, although our study has found higher D-dimer levels in patients who develop mortality, these results were not statistically significant.

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Section: Discussionmentioning

confidence: 99%

The effects of D-dimer high rates on prognosis and mortality in chronic obstructive respiratory disease

SAYMAZ

Çelik²,

Yıldız

et al. 2022

Anatolian Current Medical Journal

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show abstract

“…D-dimer is considered to be a marker for fibrinolysis and coagulation activation; however, D-dimer has also been used to predict DIC ( 8 ). Furthermore, D-dimer is considered to be a biomarker for thrombosis, and a notable increase in its levels is indicative of a poor outcome ( 9 ). The elevated level of D-dimer in the present case report was therefore a predictor for massive thrombosis in the abdominal aorta and bilateral common iliac arteries.…”

Section: Discussionmentioning

confidence: 99%

Management of a patient with cardiac arrest, intestinal ischemia necrosis, multiple fractures, hemorrhagic shock, renal failure, disseminated intravascular coagulation, and thrombosis after severe abdominal crush injury: A case report

Yang¹,

Tang

Li³

et al. 2022

Exp Ther Med

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Abdominal crush injury has been widely reported. However, abdominal crush injury cases involving most of the organ systems have seldom been reported. In the present case report, a 58-year-old man was hit in the abdomen by a 4-ton machine tool. The case described a rare combination of cardiac arrest, intestinal ischemia necrosis, multiple fractures, hemorrhagic shock, renal failure, disseminated intravascular coagulation and thrombosis after severe abdominal crush injury. During the treatment, crush syndrome, anemia, electrolyte disorder, pleural effusion, pulmonary emphysema, compartment syndrome, respiratory failure, pulmonary hemorrhage, injury of the right common peroneal nerve and tibial nerve, septum abscess and malnutrition were also observed. Systemic and symptomatic treatments were performed for >3 months, after which the patient was discharged from hospital without any further risk of fatality. The related treatments were also described in detail in the present case report. This case represented one of the most complicated cases among abdominal crush injuries that have been reported, and the treatment experiences reported here will hopefully provide suitable reference points for similar cases.

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“… 14 – 16 Elevated D-dimer levels have also been reported to be a high-risk factor in critically ill patients without COVID-19, including infectious disease, trauma, heart failure, thrombotic disease (eg cerebral thrombosis, acute myocardial infarction, VTE), intracranial bleeding, and other conditions. 17 However, there are many kits available for assaying D-dimer levels, and the standardization of D-dimer elevation for diagnosing of thrombosis is still required.…”

Section: Introductionmentioning

confidence: 99%

D-dimer kit with a High FDP/D-Dimer Ratio is Useful for Diagnosing Thrombotic Diseases

Ikeda

Wada

Ichikawa

et al. 2022

Clin Appl Thromb Hemost

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Introduction Although D-dimer is a useful biomarker of thrombosis, there are many D-dimer kits, with high and low fibrinogen and fibrin degradation products (FDP)/ D-dimer ratios. Methods Plasma D-dimer levels were measured using three different kits in critically ill patients to examine the usefulness of such measurements for detecting the thrombotic diseases and determining the correlation with the FDP and FDP/D-dimer ratio. Results Although three D-dimer kits showed marked utility for diagnosing disseminated intravascular coagulation (DIC) and peripheral arterial and venous thromboembolism (PAVTE), the D-dimer levels determined using the three kits varied among diseases. Indeed, one D-dimer kit showed a high FDP/D-dimer ratio, and another kit showed a low FDP/D-dimer ratio. D-dimer kit with low FDP/D-dimer ratio tended to have high cut-off values and low specificity for diagnosing DIC and PAVTE. In D-dimer kit with high FDP/D-dimer ratio, FDP/D-dimer ratios in patients with thrombosis was significantly higher than that in patients without thrombosis. Conclusion All three D-dimer kits show utility for detecting thrombotic diseases. However, the D-dimer levels determined using the kits varied due to differences in the FDP/D-dimer ratio. In combination with the FDP level, a D-dimer kit with a high FDP/D-dimer ratio may be useful.

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Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients

Cited by 16 publications

References 27 publications

The effects of D-dimer high rates on prognosis and mortality in chronic obstructive respiratory disease

The effects of D-dimer high rates on prognosis and mortality in chronic obstructive respiratory disease

Management of a patient with cardiac arrest, intestinal ischemia necrosis, multiple fractures, hemorrhagic shock, renal failure, disseminated intravascular coagulation, and thrombosis after severe abdominal crush injury: A case report

D-dimer kit with a High FDP/D-Dimer Ratio is Useful for Diagnosing Thrombotic Diseases

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