Critical Care: Critical Care: Sepsis |

The Value of D-dimer on Illness Surveillance and Prognosis Evaluation of Sepsis: A Retrospective Study FREE TO VIEW

Kun Xiao, MD; Lixin Xie
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Chinese People's Liberation Army (PLA) General Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A169. doi:10.1016/j.chest.2016.02.175
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SESSION TITLE: Critical Care: Sepsis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Serum markers can be important indicators for the treatment monitoring and the prognostic assessment in sepsis patients. The aim of the study was to investigate the value of D-dimer (DD) on illness surveillance and predicting 28-day mortality of sepsis patients.

METHODS: A total of 641 patients with different stages of sepsis and 150 systemic inflammatory response syndrome (SIRS) patients with no sepsis diagnosed were enrolled retrospectively. Circulation levels of C reactive protein (CRP), procalcitonon (PCT), and D-dimer as well as Sepsis-related Organ Failure Assessment Scores and Acute Physiology and Chronic Health Evaluation II were recored within 24 hours of ICU adminssion.

RESULTS: Compared to SIRS group, admission levels of plasma D-dimer in sepsis group showed no significantly difference (p>0.05); Plasma levels of D-dimer were significantly positively correlated with SOFA and APACHE II scores with the coefficient of 0.625 and 0.573 (p<0.05) in sepsis. Plasma D-dimer levels, APCHE II and SOFA scores in severe sepsis were significantly higher than those sepsis group (p<0.05), and the areas under the ROC curves of D-dimer, APCHE II and SOFA scores for identification the severity of sepsis were 0.828, 0.803, and 0.848, respectively. For sepsis prognosis, the areas under the ROC curves of D-dimer, APACHE II, SOFA scores, combination of SOFA scores and D-dimer were 0.714, 0.765, 0.791, and 0.835.

CONCLUSIONS: D-dimer had limited ability to distinguish sepsis from SIRS. There were good correlation between D-dimer levels and APACHE II, SOFA scores. High levels of D-dimer could help severity monitor, and combination of D-dimer and SOFA scores performed more excellent on prognostic value for patients with sepsis than any other indicators.

CLINICAL IMPLICATIONS: Sepsis is one of major factors contributing to ICU admission and deaths. Non-specific symptoms, as well as delayed results from microorganism culture, are not conducive to rapid discrimination and early evaluation. Thus, the development of serum biomarkers for sepsis is an urgent task and a timely topic. In the retrospective study, we investigate the value of D-dimer in illness surveillance and predicting 28-day mortality of sepsis patients. We believe that these findings will be of value and interest to clinicians and ICU staffers. Thorough the use of several biomarkers, effective interventions can be attempted to improve prognosis and reduce mortality.

DISCLOSURE: The following authors have nothing to disclose: Kun Xiao, Lixin Xie

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