D-dimer in acute pancreatitis: a new approach for an early assessment of organ failure.
OBJECTIVE
Studies on the clinical value of parameters of hemostasis in predicting pancreatitis-associated complications are still scarce. The aim of this prospective study was to identify the useful hemostatic markers for accurate determination of the subsequent development of organ failure (OF) during the very early course of acute pancreatitis (AP).


METHODS
In 91 consecutive primarily admitted patients with AP, prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin III, protein C, plasminogen activator inhibitor 1, D-dimer, and plasminogen were measured in plasma within the first 24 hours of admission and 24 hours thereafter. Two study groups comprising 24 patients with OF and 67 patients without OF were compared.


RESULTS
Levels of prothrombin time, fibrinogen, and D-dimer on admission were significantly different between the OF and non-OF groups, and all these parameters plus antithrombin III were significantly different 24 hours later. A D-dimer value of 414.00 microg/L on admission was the best cutoff value in predicting the development of OF with sensitivity, specificity, and positive and negative predictive values of 90%, 89%, 75%, and 96%, respectively.


CONCLUSIONS
Measurement of plasma levels of D-dimer on the admission is an accurate method for the identification of patients who will develop OF in the further course of AP.
Center for Emergency Surgery, School of Medicine, Surgical Department, University of Belgrade, Belgrade, Serbia. dejanr@sbb.co.yu
Dejan
D
Radenkovic
Djordje
D
Bajec
Nenad
N
Ivancevic
Natasa
N
Milic
Vesna
V
Bumbasirevic
Vasilije
V
Jeremic
Vladimir
V
Djukic
Branislava
B
Stefanovic
Branislav
B
Stefanovic
Gorica
G
Milosevic-Zbutega
Pavle
P
Gregoric
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000209:etiology*; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000097:blood* / Q000150:complications*; D011446:Prospective Studies; D012372:ROC Curve
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D