Prognostic value of plasma D-dimer level in adults with community-acquired pneumonia: A prospective study

Duarte, Joana; Castro, Ana Tavares e; Silva, Raquel; Correia, Lurdes; Simão, Adélia; Carvalho, Armando

doi:10.1016/j.rppnen.2015.02.007

Cited by 7 publications

(8 citation statements)

References 7 publications

(11 reference statements)

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“…Recommended thresholds of different d-dimer assays varied widely across studies. Cut-off values were determined as 500 or 1000 ng/mL in 7 studies [ 33 , 41 , 48 , 53 , 56 – 58 ]. ELISA method was used in 7 studies [ 34 , 35 , 38 , 43 , 45 , 48 , 59 ]; immunoturbidimetric methods were used in 7 studies [ 31 , 36 , 37 , 40 , 44 , 53 , 60 ] and quantitative latex assay were launched in six studies [ 32 , 37 , 39 , 41 , 55 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

Value of D-dimer in predicting various clinical outcomes following community-acquired pneumonia: A network meta-analysis

Zhou

Duan

et al. 2022

PLoS ONE

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Background Whether high D-dimer level before treatment has any impact on poor outcomes in patients with community-associated pneumonia (CAP) remains unclear. Therefore, we conducted the first meta-analysis focusing specifically on prognostic value of high D-dimer level before treatment in CAP patients. Methods Pubmed, Embase, the Cochrane Central Register of Controlled Trials and World Health Organization clinical trials registry center were searched up to the end of March 2021. Randomized clinical trials (RCT) and observational studies were included to demonstrate the association between the level of D-dimer and clinical outcomes. Data were extracted using an adaptation of the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies (CHARMS-PF). When feasible, meta-analysis using random-effects models was performed. Risk of bias and level of evidence were assessed with the Quality in Prognosis Studies tool and an adaptation of Grading of Recommendations Assessment, Development, and Evaluation. Data were analyzed using STATA 14.0 to complete meta and network analysis. Main outcomes and measures Besides d-dimer levels in CAP patients with poor outcomes, we also analyzed proportion of patients with or without poor outcomes correctly classified by the d-dimer levels as being at high or low risk. The poor outcome includes severe CAP, death, pulmonary embolism (PE) and invasive mechanical ventilators. Results 32 studies with a total of 9,593 patients were eventually included. Pooled effect size (ES) suggested that d-dimer level was significantly higher in severe CAP patients than non-severe CAP patients with great heterogeneity (SMD = 1.21 95%CI 0.87–1.56, I2 = 86.8% p = 0.000). D-dimer level was significantly elevated in non-survivors compared to survivors with CAP (SMD = 1.22 95%CI 0.67–1.77, I2 = 85.1% p = 0.000). Prognostic value of d-dimer for pulmonary embolism (PE) was proved by hierarchical summary receiver operating characteristic curve (HSROC) with good summary sensitivity (0.74, 95%CI, 0.50–0.89) and summary specificity (0.82, 95%CI, 0.41–0.97). Network meta-analysis suggested that there was a significant elevation of d-dimer levels in CAP patients with poor outcome than general CAP patients but d-dimer levels weren’t significantly different among poor outcomes. Conclusion The prognostic ability of d-dimer among patients with CAP appeared to be good at correctly identifying high-risk populations of poor outcomes, suggesting potential for clinical utility in patients with CAP.

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Section: Resultsmentioning

confidence: 99%

Value of D-dimer in predicting various clinical outcomes following community-acquired pneumonia: A network meta-analysis

Zhou

Duan

et al. 2022

PLoS ONE

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“…36 However, there is currently no conclusive evidence supporting the use of D-dimer as an evaluation index. [37][38][39] A broad sample analysis is required to determine whether D-dimer is associated with COVID-19 severity. Therefore, the present study does not consider this parameter as an evaluation index for disease progression.…”

Section: Discussionmentioning

confidence: 99%

“…suggested a correlation among D‐dimer, FDP, and COVID‐19 severity 36 . However, there is currently no conclusive evidence supporting the use of D‐dimer as an evaluation index 37–39 . A broad sample analysis is required to determine whether D‐dimer is associated with COVID‐19 severity.…”

Section: Discussionmentioning

confidence: 99%

The Potential of Low Molecular Weight Heparin to Mitigate Cytokine Storm in Severe COVID‐19 Patients: A Retrospective Cohort Study

Chen

Wang

et al. 2020

Clinical Translational Sci

142

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On March 11, 2020, the World Health Organization declared its assessment of coronavirus disease 2019 (COVID-19) as a global pandemic. However, specific anti-severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) drugs are still under development, and patients are managed by multiple complementary treatments. We performed a retrospective analysis to compare and evaluate the effect of low molecular weight heparin (LMWH) treatment on disease progression. For this purpose, the clinical records and laboratory indicators were extracted from electronic medical records of 42 patients with COVID-19 (21 of whom were treated with LMWH, and 21 without LMWH) hospitalized (Union Hospital of Huazhong University of Science and Technology) from February 1 to March 15, 2020. Changes in the percentage of lymphocytes before and after LMWH treatment were significantly different from those in the control group (P = 0.011). Likewise, changes in the levels of D-dimer and fibrinogen degradation products in the LMWH group before and after treatment were significantly different from those in the control group (P = 0.035). Remarkably, IL-6 levels were significantly reduced after LMWH treatment (P = 0.006), indicating that, besides other beneficial properties, LMWH may exert an anti-inflammatory effect and attenuate in part the "cytokine storm" induced by the virus. Our results support the use of LMWH as a potential therapeutic drug for the treatment of COVID-19, paving the way for a subsequent well-controlled clinical study. On March 11, 2020, the World Health Organization (WHO) declared its assessment of coronavirus disease 2019 (COVID-19) as a global pandemic. Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is characterized by a long incubation period, high infectivity, and multiple routes of transmission. 1,2 However, no effective medicines are currently available, so patients are treated symptomatically. A better understanding of the mechanisms of pathological changes will help to screen potential drugs out of the currently available medications. Several clinical studies revealed that cytokine storms are important mechanisms underlying disease exacerbation and death of patients with COVID-19. 3-5 Particularly, IL-6 levels in severely ill patients were significantly higher than in mild cases. 6 IL-6 is one of the core cytokines, 7 contributing to many of the key symptoms of cytokine storm, such

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“…D-D plays an important role in the occurrence and development of inflammation. When the body is infected, a variety of inflammatory factors will be released, damaging the vascular endothelial cells and resulting in decline in function, which activates the coagulation system, consumes a large number of coagulation factors and causes the patient's blood into hypercoagulable state ( 20 ). The results of this study showed that at 3, 5 and 7 days after effective treatment strategies were taken, the SOFA score, PCT, D-D and CRP levels in the two groups were significantly decreased, and they were obviously higher in observation group than those in the control group (P<0.05).…”

Section: Discussionmentioning

confidence: 99%

Risk factors and coping strategies of severe community-acquired pneumonia in chemotherapy induction period of acute leukemia

Duan

Zhang

2018

Oncol Lett

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The risk factors and coping strategies of severe community-acquired pneumonia (SCAP) in chemotherapy induction period of acute leukemia were investigated. Eighty-six patients with CAP in chemotherapy induction period of acute leukemia in Dezhou Hospital from March 2014 to February 2017 were selected and divided into observation group (SCAP group, n=45) and control group (non-SCAP group, n=41) according to the acute physiology and chronic health evolution II (APACHE II) score. The blood, sputum, nasopharyngeal secretion and pleural effusion samples were collected from patients in both groups, and the samples were detected for pathogens, followed by the analysis of relevant factors. The dynamic changes in the sequential organ failure assessment (SOFA) score, procalcitonin (PCT), D-dimer (D-D) and C-reactive protein (CRP) levels in patients were observed before and after the corresponding treatment strategies were taken. The total distribution ratio of pathogens from high to low in the two groups was as follows: bacterium, virus, fungus, mycoplasma and chlamydia trachomatis; there was no significant difference between the two groups (P>0.05). Logistic regression analysis showed that the repeated infection (OR=3.315, P=0.005), multi-resistant bacterial infection (OR=1.915, P=0.008) and D-D (OR=1.936, P=0.009) were independent risk factors for SCAP (P<0.05). After different coping strategies were taken, the SOFA score, PCT, D-D and CRP levels in the two groups were significantly decreased, and they were obviously higher in observation group than those in control group (P<0.05). Repeated infection, D-D level and multi-resistant bacterial infection are the risk factors affecting the SCAP in chemotherapy induction period of acute leukemia. The coping strategies can effectively relieve the patient's condition, reduce the severity of disease and improve the survival rate of patients.

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Prognostic value of plasma D-dimer level in adults with community-acquired pneumonia: A prospective study

Cited by 7 publications

References 7 publications

Value of D-dimer in predicting various clinical outcomes following community-acquired pneumonia: A network meta-analysis

Value of D-dimer in predicting various clinical outcomes following community-acquired pneumonia: A network meta-analysis

The Potential of Low Molecular Weight Heparin to Mitigate Cytokine Storm in Severe COVID‐19 Patients: A Retrospective Cohort Study

Risk factors and coping strategies of severe community-acquired pneumonia in chemotherapy induction period of acute leukemia

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