Association Between D-Dimer Level and In-Hospital Death of Pulmonary Embolism Patients. Issue 4 (4th December 2020)

• Record Type: Journal Article
• Authors: Song, Zi-Kai; Wu, Haidi; Xu, Xiaoyan; Cao, Hongyan; Wei, Qi; Wang, Junfeng; Wang, Xingwen; Zhang, Xue; Tang, Minglong; Yang, Shuo; Liu, Yang; Qin, Ling
• Is Part Of: Dose-response. Volume 18:Issue 4(2020)
• Publication Date: 2020-12-04
• Subjects: pulmonary embolism -- D-dimer -- in-hospital death -- sPESI; Dose-response relationship (Biochemistry) -- Periodicals; Drugs -- Dose-response relationship -- Periodicals; Drugs -- Physiological effect -- Periodicals; Hormesis -- Periodicals; Dose-Response Relationship, Drug -- Periodicals; Dose-response relationship (Biochemistry); Drugs -- Dose-response relationship; Drugs -- Physiological effect; Periodicals; 571.634
• DOI: 10.1177/1559325820968430
• Languages: English
• ISSNs: 1559-3258

Abstract

To investigate whether D-dimer level could predict pulmonary embolism (PE) severity and in-hospital death, a total of 272 patients with PE were divided into a survival group (n = 249) and a death group (n = 23). Comparisons of patient characteristics between the 2 groups were performed using Mann-Whitney U test. Significant variables in univariate analysis were entered into multivariate logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of D-dimer level alone or together with the simplified Pulmonary Embolism Severity Index (sPESI) for in-hospital death. Results showed that patients in the death group were significantly more likely to have hypotension (P = 0.008), tachycardia (P = 0.000), elevated D-dimer level (P = 0.003), and a higher sPESI (P = 0.002) than those in the survival group. Multivariable logistic regression analysis showed that D-dimer level was an independent predictor of in-hospital death (OR = 1.07; 95% CI, 1.003-1.143; P = 0.041). ROC curve analysis showed that when D-dimer level was 3.175 ng/ml, predicted death sensitivity and specificity were 0.913 and 0.357, respectively; and when combined with sPESI, specificity (0.838) and area under the curve (0.740) were increased. Thus, D-dimer level is associated with in-hospital death due to PE; and the combination with sPESI can improve the prediction level.