Serum D-dimer levels at admission for prediction of outcomes in acute pancreatitis

Wan, Jianhua; Yang, Xiaoyu; He, Wenhua; Zhu, Yin; Zhu, Yong; Zeng, Hao; Pi, Li; Xia, Liang; Lü, Nonghua

doi:10.1186/s12876-019-0989-x

Cited by 37 publications

(30 citation statements)

References 44 publications

(52 reference statements)

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“…Recently, a series of diagnostic and prognostic markers alone and in combination have been evaluated in patients with AP [35][36][37] . Although numerous available biomarkers have been proposed for the prediction of prognosis, there remains a lack of specific biomarkers for the early and reliable prediction of AP severity.…”

Section: Discussionmentioning

confidence: 99%

Deceased serum bilirubin and albumin levels in the assessment of severity and mortality in patients with acute pancreatitis

Xu¹,

Ai²,

Huang³

2020

Int. J. Med. Sci.

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Background: Our study investigated the diagnostic and prognostic role of serum antioxidant indexes in patients with acute pancreatitis (AP). Methods: This study included 708 AP patients from the Medical Information Mart for Intensive Care-III (MIMIC-III) database and 477 patients from the eICU Collaborative Research Database (eICU-CRD). X-tile software was applied to determine the best cutoff values for serum antioxidant indexes. Univariate and multivariate regression analyses were employed to select variables associated with severe AP (SAP) and in-hospital mortality. Finally, the nomograms were also externally validated in the eICU-CRD. Results: The best cutoff values for serum total bilirubin (TBIL) and albumin were 1.1 mg/dL and 2.1 g/dL in the training set, respectively. Multivariate logistical regression indicated that both TBIL (odds ratio [OR]=0.740, 95% confidence interval [CI]: 0.616-0.889, P=0.001) and albumin (OR=0.890, 95%CI: 0.819-0.967, P=0.006) were independent risk factors for SAP. Similarly, multivariate Cox analysis revealed that serum TBIL (hazard ratio [HR]=0.768, 95%CI:0.635-0.928, P=0.006) and albumin (HR=0.962, 95%CI:0.927-0.998, P=0.037) were independent risk factors for in-hospital mortality in AP patients. The diagnostic nomogram containing TBIL, albumin, Sequential Organ Failure Assessment (SOFA) score and urea nitrogen and prognostic nomogram combining TBIL, albumin, white blood count, SOFA score, and age obtained good discrimination, calibration and clinical utility in both the MIMIC-III and eICU-CRD. Conclusion: Serum TBIL and albumin were independent predictors for SAP and in-hospital mortality in AP patients. The nomograms combining serum TBIL and albumin with other significant features exerted favorable predictive performance for SAP and in-hospital mortality.

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Section: Discussionmentioning

confidence: 99%

Deceased serum bilirubin and albumin levels in the assessment of severity and mortality in patients with acute pancreatitis

Xu¹,

Ai²,

Huang³

2020

Int. J. Med. Sci.

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“…Radenkovic et al [186] verified D-dimer as a novel marker for predicting organ failure, with a sensitivity of 90% and NPV of 96% for a cut-off level of 414.00 microg/L. Several studies show that D-dimer is an easy, useful, and inexpensive early prognostic marker of severe AP [186,187].…”

Section: D-dimermentioning

confidence: 99%

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

Silva-Vaz

Abrantes

Castelo‐Branco

et al. 2020

IJMS

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Acute pancreatitis (AP) is a severe inflammation of the pancreas presented with sudden onset and severe abdominal pain with a high morbidity and mortality rate, if accompanied by severe local and systemic complications. Numerous studies have been published about the pathogenesis of AP; however, the precise mechanism behind this pathology remains unclear. Extensive research conducted over the last decades has demonstrated that the first 24 h after symptom onset are critical for the identification of patients who are at risk of developing complications or death. The identification of these subgroups of patients is crucial in order to start an aggressive approach to prevent mortality. In this sense and to avoid unnecessary overtreatment, thereby reducing the financial implications, the proper identification of mild disease is also important and necessary. A large number of multifactorial scoring systems and biochemical markers are described to predict the severity. Despite recent progress in understanding the pathophysiology of AP, more research is needed to enable a faster and more accurate prediction of severe AP. This review provides an overview of the available multifactorial scoring systems and biochemical markers for predicting severe AP with a special focus on their advantages and limitations.

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“…Elevations in D-dimer are common in critical illness and are associated with disease severity and mortality in many severe infections. [29][30][31] Patients with influenza, SARS, HIV, hantavirus, Ebola virus, and dengue have elevations in D-dimer, prothrombin fragments, thrombin-antithrombin complexes, and/or plasmin-α 2 -antiplasmin complexes. 32 Similar to patients with SARS-CoV-2 infections, there is an association between elevated D-dimer and mortality in patients with H1N1 and H5N1, which is not seen in SARS.…”

Section: Coagulopathy Of Sars-cov-2 and Other Infectionsmentioning

confidence: 99%

COVID–19-associated coagulopathy: An exploration of mechanisms

2020

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An ongoing global pandemic of viral pneumonia (coronavirus disease [COVID-19]), due to the virus SARS-CoV-2, has infected millions of people and remains a threat to many more. Most critically ill patients have respiratory failure and there is an international effort to understand mechanisms and predictors of disease severity. Coagulopathy, characterized by elevations in D-dimer and fibrin(ogen) degradation products (FDPs), is associated with critical illness and mortality in patients with COVID-19. Furthermore, increasing reports of microvascular and macrovascular thrombi suggest that hemostatic imbalances may contribute to the pathophysiology of SARS-CoV-2 infection. We review the laboratory and clinical findings of patients with COVID-19-associated coagulopathy, and prior studies of hemostasis in other viral infections and acute respiratory distress syndrome. We hypothesize that an imbalance between coagulation and inflammation may result in a hypercoagulable state. Although thrombosis initiated by the innate immune system is hypothesized to limit SARS-CoV-2 dissemination, aberrant activation of this system can cause endothelial injury resulting in loss of thromboprotective mechanisms, excess thrombin generation, and dysregulation of fibrinolysis and thrombosis. The role various components including neutrophils, neutrophil extracellular traps, activated platelets, microparticles, clotting factors, inflammatory cytokines, and complement play in this process remains an area of active investigation and ongoing clinical trials target these different pathways in COVID-19.

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Serum D-dimer levels at admission for prediction of outcomes in acute pancreatitis

Cited by 37 publications

References 44 publications

Deceased serum bilirubin and albumin levels in the assessment of severity and mortality in patients with acute pancreatitis

Deceased serum bilirubin and albumin levels in the assessment of severity and mortality in patients with acute pancreatitis

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

COVID–19-associated coagulopathy: An exploration of mechanisms

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