D-dimer assay predicts mortality in critically ill patients without disseminated intravascular coagulation or venous thromboembolic disease.
OBJECTIVE
To determine if D-dimer predicts outcomes in critically ill patients.


METHODS
Observational, cohort study.


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


METHODS
Seventy-four patients consecutively admitted to the MICU.


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


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).
Shorr
A F
AF
Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307, USA. Andrew_F.Shorr@WRAMAA.CHCS.AMEDD.ARMY.MIL
Trotta
R F
RF
Alkins
S A
SA
Hanzel
G S
GS
Diehl
L F
LF
D018806:APACHE; D000368:Aged; D015415:Biomarkers; D015331:Cohort Studies; D004211:Disseminated Intravascular Coagulation; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007841:Latex Fixation Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D020246:Venous Thrombosis
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D