D-dimer levels in predicting the severity of acute pancreatitis

Anil Kumar M. S.; Ranjith Kothagattu

doi:10.18203/2349-2902.isj20175398

Authors

Anil Kumar M. S. Department of Surgery, JSS Medical College, Mysore, Karnataka, India
Ranjith Kothagattu Department of General Surgery, JSS Medical College, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175398

Keywords:

Acute pancreatitis, D-Dimer, Multiple organ dysfunction syndrome, Pancreatic infection

Abstract

Background:Coagulative disorder is known to occur in the early phase of acute pancreatitis. (AP) and D-dimer is a commonly used clinical parameter of haemostasis. The aim of this study was to assess the value of the plasma D-dimer level as a marker of severity in the 1.3.5 days after admission in patients with Acute pancreatitis.

Methods: From September 2015 to September 2017, 60 patients admitted for AP were included in this observational study. The D-dimer level was measured during days 1,3,5 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 AP.

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 mortality. Additionally, the D-dimer level correlated well with two usual markers of AP severity-the APACHE II score and the C-reactive protein level. Conclusion D-dimer measurement is a useful, easy, and inexpensive early prognostic marker of the evolution and complications of AP.

Conclusions:D-dimer measurement is a useful, easy, and inexpensive early prognostic marker of the evolution and complications of SAP.

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References

Appelros S, Lindgren S, Borgstrom A. Short and long-term outcome of severe acute pancreatitis. Eur J Surg. 2001;167(4):281-6.

Salomone T, Tosi P, Palareti G, Tomassetti P, Migliori M, Guariento A, et al. Coagulative disorders in human acute pancreatitis: role for the D-dimer. Pancreas. 2003;26(2):111-6.

Agarwal N, Pitchumoni CS. Acute pancreatitis: a multisystem disease. Gastroenterologist. 1993;1(2):115-28.

Radenkovic D, Bajec D, Ivancevic N, Milic N, Bumbasirevic V, Jeremic V, et al. D-dimer in acute pancreatitis: a new approach for an early assessment of organ failure. Pancreas. 2009;38(6):655-60.

Maeda K, Hirota M, Ichihara A, Ohmuraya M, Hashimoto D, Sugita H, et al. Applicability of disseminated intravascular coagulation parameters in the assessment of the severity of acute pancreatitis. Pancreas. 2006;32(1):87-92.

Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer J, et al. Evaluation of D-dimer in the diagnosis of suspected deepvein thrombosis. N Engl J Med. 2003;349(13):1227-35.

Van Belle A, Buller HR, Huisman MV, Huisman PM, Kaasjager K, Kamphuisen PW, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA. 2006;295(2):172-9.

Uhl W, Warshaw A, Imrie C, Bassi C, McKay CJ, Lankisch PG, et al. IAP guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2(6):565-73.

Jones AE, Trzeciak S, Kline JA. The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med. 2009;37(5):1649-54.

Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2):331-6.

Ranson JH, Lackner H, Berman IR, Schinella R. The relationship of coagulation factors to clinical complications of acute pancreatitis. Surgery. 1977;81(5):502-11.

Redha F, Uhlschmid G, Ammann RW, Freiburghaus AU. Injection of microspheres into pancreatic arteries causes acute hemorrhagic pancreatitis in the rat: a new animal model. Pancreas. 1990;5(2):188-93.

Beger HG, Rau BM. Severe acute pancreatitis: clinical course and management. World J Gastroenterol. 2007;13(38):5043-51.

Beger HG, Rau B, Isenmann R. Natural history of necrotizing pancreatitis. Pancreatology. 2003;3(2):93-101.