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

Abstract

OBJECTIVE:

To determine if D-dimer predicts outcomes in critically ill patients.

DESIGN:

Observational, cohort study.

SETTING:

Medical intensive care unit (MICU) of a tertiary care hospital.

PATIENTS AND PARTICIPANTS:

Seventy-four patients consecutively admitted to the MICU.

INTERVENTIONS:

D-dimer was measured by latex agglutination within 12 h of admission to the MICU.

MEASUREMENTS AND RESULTS:

Of the study population, 43.2% had positive D-dimers. The in-hospital mortality rate in D-dimer positive patients was 28.1% as compared to 7.1% in D-dimer negative subjects (p = 0.024). D-dimer positive patients had significantly greater frequencies of venous thromboses (21.9% vs 4.8%, p = 0.035).

CONCLUSIONS:

The D-dimer assay identifies patients at increased risk for mortality and may be a more sensitive test to determine the presence of underlying microvascular pathology in critically ill patients. A positive D-dimer at admission to the MICU is associated with an increased risk for the later development of a venous thromboembolic event (VTE).

• Authors: A F Shorr, R F Trotta, S A Alkins, G S Hanzel, L F Diehl
• Journal: Intensive care medicine (Intensive Care Med) Vol. 25 Issue 2 Pg. 207-10 (Feb 1999) ISSN: 0342-4642 [Print] United States
• PMID: 10193549 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Biomarkers
• Fibrin Fibrinogen Degradation Products
• fibrin fragment D

Topics

• APACHE
• Aged
• Biomarkers
• Cohort Studies
• Disseminated Intravascular Coagulation
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• Hospital Mortality
• Humans
• Intensive Care Units
• Latex Fixation Tests
• Logistic Models
• Male
• Middle Aged
• Predictive Value of Tests
• Prognosis
• Venous Thrombosis