title: D-dimer as an early marker of severity in patients with acute superior mesenteric venous thrombosis.
abstract: No early serum marker of disease severity contributes to the treatment decision-making process of acute superior mesenteric venous thrombosis (ASMVT). This study aims to assess the value of serum D-dimer level in the first 3 days after admission as a severity marker of ASMVT patients. From May 2010 to June 2014, 50 consecutive patients of ASMVT were enrolled in this observational study. The serum D-dimer level was measured on a daily basis during the first 3 days after admission as well as other laboratory-testing parameters, clinical score, and outcome variables recorded during the same period. The maximum and mean D-dimer values were analyzed and compared with other potential markers for prediction of multiple-organ dysfunction syndrome (MODS) and short-bowel syndrome (SBS). The correlation of D-dimer level with other potential severity markers and inflammation parameters were also studied. Both maximum and mean D-dimer level during the first 3 days of admission were significantly higher in patients with several clinical variables such as death within 30 days, bowel resection, sepsis, abdominal compartment syndrome, MODS, and SBS. In addition, serum D-dimer level showed precise prediction for MODS and SBS, greater than L-lactate and intestinal-type fatty acid-binding protein (I-FABP). The D-dimer level was correlated well with L-lactate, I-FABP, and APACHE II score on the first 3 days of admission. Poor correlation of D-dimer level and inflammation parameters, white blood cell count, and C-reactive protein level, was detected. D-dimer level could be an effective, early, and specific serum marker indicating the clinical evolution and outcome of ASMVT.
authors.affiliation: From the Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, P.R. China.
authors.forename: Shuofei
authors.initials: S
authors.lastname: Yang
authors.forename: Xinxin
authors.initials: X
authors.lastname: Fan
authors.forename: Weiwei
authors.initials: W
authors.lastname: Ding
authors.forename: Baochen
authors.initials: B
authors.lastname: Liu
authors.forename: Jiaxiang
authors.initials: J
authors.lastname: Meng
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.forename: Xingjiang
authors.initials: X
authors.lastname: Wu
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D018806:APACHE; D000328:Adult; D015415:Biomarkers / Q000097:blood; D042241:Early Diagnosis; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D065666:Mesenteric Ischemia / Q000097:blood* / Q000175:diagnosis*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000175:diagnosis; D010446:Peptide Fragments / Q000097:blood; D010865:Pilot Projects; D012720:Severity of Illness Index; D012778:Short Bowel Syndrome / Q000097:blood / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; C036309:fibrin fragment D; C527661:intestinal fatty acid-binding protein (1-19), human; D019344:Lactic Acid