Association Between D-Dimer Level and In-Hospital Death of Pulmonary Embolism Patients

• Main Authors: Zi-Kai Song PhD (Author), Haidi Wu MD (Author), Xiaoyan Xu MD (Author), Hongyan Cao MD (Author), Qi Wei MD (Author), Junfeng Wang MD (Author), Xingwen Wang (Author), Xue Zhang (Author), Minglong Tang (Author), Shuo Yang (Author), Yang Liu (Author), Ling Qin PhD (Author)
• Format: Book
• Published: SAGE Publishing, 2020-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

To investigate whether D-dimer level could predict pulmonary embolism (PE) severity and in-hospital death, a total of 272 patients with PE were divided into a survival group (n = 249) and a death group (n = 23). Comparisons of patient characteristics between the 2 groups were performed using Mann-Whitney U test. Significant variables in univariate analysis were entered into multivariate logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of D-dimer level alone or together with the simplified Pulmonary Embolism Severity Index (sPESI) for in-hospital death. Results showed that patients in the death group were significantly more likely to have hypotension (P = 0.008), tachycardia (P = 0.000), elevated D-dimer level (P = 0.003), and a higher sPESI (P = 0.002) than those in the survival group. Multivariable logistic regression analysis showed that D-dimer level was an independent predictor of in-hospital death (OR = 1.07; 95% CI, 1.003-1.143; P = 0.041). ROC curve analysis showed that when D-dimer level was 3.175 ng/ml, predicted death sensitivity and specificity were 0.913 and 0.357, respectively; and when combined with sPESI, specificity (0.838) and area under the curve (0.740) were increased. Thus, D-dimer level is associated with in-hospital death due to PE; and the combination with sPESI can improve the prediction level.

Item Description

1559-3258
10.1177/1559325820968430