Mean serum D-dimer level to predict in-hospital mortality in COVID-19


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Hayiroglu M. İ., Cicek V., Kilic S., Cinar T.

REVISTA DA ASSOCIACAO MEDICA BRASILEIRA, cilt.67, sa.3, ss.437-442, 2021 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 67 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1590/1806-9282.20200896
  • Dergi Adı: REVISTA DA ASSOCIACAO MEDICA BRASILEIRA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
  • Sayfa Sayıları: ss.437-442
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır

Özet

OBJECTIVE: The prognostic effect of the mean serum D-dimer levels, which was calculated from the first five days of hospitalization of the patients, has not been elucidated. This study aimed to evaluate the effect of mean D-dimer level about in-hospital mortality in patients hospitalized due to coronavirus disease-2019 (COVID-19) infection. METHODS: In this observational retrospective study, we examined the in-hospital prognostic value of mean D-dimer [D-dimerfirst day +D-dimerthird day +D-dimerfifth day)/3 on 240 consecutive adult patients with COVID-19. Patients were stratified into tertiles according to their mean D-dimer starting from the lowest one. In-hospital mortality rates were compared between tertiles and the power of the mean D-dimer level was also presented by a receiver operating curve analysis. RESULTS: After adjustment for confounding baseline variables, mean D-dimer in tertile 3 was associated with 4.2-fold hazard ratio of in-hospital mortality (odds ratio [OR] 4.2; 95% confidence interval [CI] 1.8-20.1, p<0.001). A receiver-operating curve analysis revealed that the optimal cutoff value of the mean D-dimer to predict in-hospital mortality was 779 mu g/L with 77% sensitivity and 83% specificity (area under the curve [AUC] 0.87; 95%CI 0.81-0.94; p<0.001). CONCLUSION: Patients with a higher mean D-dimer level should be followed-up more closely as they may be a candidate for a more aggressive treatment modality, such as biologic agents or convalescent plasma.