Elevated Plasma D-Dimer in Adult Community-Acquired Pneumonia Patients is Associated with an Increased Inflammatory Reaction and Lower Survival

被引：52

作者：

Ge, Yan L. ^{[1
]}

Liu, Cong H. ^{[2
]}

Wang, Nan ^{[3
]}

Xu, Jing ^{[1
]}

Zhu, Xiao Y. ^{[1
]}

Su, Chuan S. ^{[1
]}

Li, Hui L. ^{[1
]}

Zhang, Hai F. ^{[1
]}

Li, Zhen Z. ^{[1
]}

Li, Hong L. ^{[1
]}

Zhang, Xue ^{[1
]}

Chen, Hao ^{[4
]}

Yu, Hua L. ^{[1
]}

Fu, Ai S. ^{[1
]}

Wang, Hong Y. ^{[1
]}

机构：

[1] North China Univ Sci & Technol, Affiliated Hosp, Dept Resp Med, Jianshe Rd 73, Tangshan 063000, Hebei, Peoples R China

[2] North China Univ Sci & Technol, Affiliated Hosp, Dept Internal Med, Tangshan, Hebei, Peoples R China

[3] North China Univ Sci & Technol, Affiliated Hosp, Dept Sci & Educ, Tangshan, Hebei, Peoples R China

[4] North China Univ Sci & Technol, Affiliated Hosp, Dept Cardiovasc Med, Tangshan, Hebei, Peoples R China

来源：

CLINICAL LABORATORY | 2019年 / 65卷 / 1-2期

关键词：

CAP; D-Dimer; pneumonia severity; prognosis; MORTALITY; PROTEIN; SEVERITY; CURB-65;

D O I：

10.7754/Clin.Lab.2018.180720

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

100118 [医学信息学]; 100208 [临床检验诊断学];

摘要：

Background: Community-acquired pneumonia (CAP) is a common infectious disease. Inflammatory reaction and prognosis assessment in adult CAP patients are useful for CAP site of care decisions. Most CAP patients were diagnosed in an out-patient or emergency department, so a simple, cheap and rapidly available measurement to assess inflammatory reaction and prognosis has the prospect of broad application. The aim of this study was to investigate the usefulness of plasma D-Dimer in assessment of inflammatory reaction and prognosis in adult CAP patients. Methods: A retrospective study was conducted. All adult patients with a primary diagnosis of CAP were included and were evaluated by peripheral plasma D-Dimer test. All of the measurement data were analyzed with paired t-test and the enumeration data were analyzed with chi(2) test. Correlative factor analysis was performed between D-Dimer levels and serum inflammatory markers (WBC, hs-CRP, PCT) and prognostic indexes (ICU admission and 30-day mortality). Receiver operating characteristic curves (ROC) were used to evaluate the sensitivity and specificity of D-Dimer in predicting ICU admission and/or 30-day mortality. Results: One hundred fifty patients were included. Compared with non-D-Dimer elevated group, serum inflammatory markers (WBC, hs-CRP, PCT) and prognostic indexes (ICU admission and 30-day mortality) were elevated in the D-Dimer elevated group (p < 0.05). D-Dimer had positive correlation with serum inflammatory markers (WBC, hs-CRP, PCT), the rates of ICU admission and 30-day mortality, and scores of CURB-65. The AUC of ROC curve of D-Dimer was 0.880 (95% CI 0.823 to 0.936), the sensitivity was 80.4% and specificity was 79.8%, D-Dimer levels are superior to hs-CRP and PCT in predicting 30-day mortality and/or ICU admission according to AUCs of the ROC curves. Conclusions: Elevated plasma D-Dimer in adult CAP patients is associated with an increased inflammatory reaction and ICU admission and 30-day mortality. It can be a simple, cheap, and rapidly available measurement to assess inflammatory reaction and prognosis in adult CAP patients.

引用

页码：131 / 138

页数：8

共 18 条

[1]

Incidence, timing and risk factors associated with 1-year mortality after hospitalization for community-acquired pneumonia [J].