title: D-dimer as a marker of severity in patients with severe acute pancreatitis.
abstract: OBJECTIVE
  Coagulative disorder is known to occur in the early phase of severe acute pancreatitis (SAP) and D: -dimer is a commonly used clinical parameter of hemostasis. The aim of this study was to assess the value of the plasma D: -dimer level as a marker of severity in the first 3 days after admission in patients with SAP.
  
  
  METHODS
  From January 2009 to February 2011, 45 patients admitted for SAP were included in this observational study. The D: -dimer level was measured on a daily basis during days 1-3 after admission and the acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, and other clinical parameters were recorded at the same time. The maximum and the mean D: -dimer values were used for analysis and compared with other prognostic factors of SAP.
  
  
  RESULTS
  Both the maximum and mean levels of D: -dimer were significantly different between patients with and without clinical variables such as multiple-organ dysfunction syndrome (MODS), need for surgical intervention, and the presence of pancreatic infection. The D: -dimer level also showed great precision for the prediction of MODS and secondary infection. Additionally, the D: -dimer level correlated well with two usual markers of SAP severity-the APACHE II score and the C-reactive protein level.
  
  
  CONCLUSIONS
  D: -dimer measurement is a useful, easy, and inexpensive early prognostic marker of the evolution and complications of SAP.
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Ke
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Ni
authors.forename: Zhi-Hui
authors.initials: ZH
authors.lastname: Tong
authors.forename: Wei-Qin
authors.initials: WQ
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jie-Shou
authors.initials: JS
authors.lastname: Li
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D003937:Diagnosis, Differential; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005500:Follow-Up Studies; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood* / Q000175:diagnosis; D055503:Protein Multimerization; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D