Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients

Ichkawa, Yuhuko; Wada, Hideo; Ezaki, Minoru; Tanaka, Motoko; Hiromori, Shinya; Shiraki, Katsuya; Moritani, Isao; Yamamoto, Akitaka; Tashiro, Haruhiko; Shimpo, Hideto; Shimaoka, Motomu

D-dimer is a biomarker of thrombosis and recently been considered to predict a poor outcome in patients with infectious diseases. Plasma D-dimer levels were measured in critically ill patients to examine their relationship with the poor outcome. The plasma D-dimer levels were markedly higher in the patients with various underlying disease especially venous thromboembolism in comparison to those without severe underlying diseases. The plasma D-dimer levels in non-survivors were significantly higher than those in survivors. In a receiver operating characteristic analysis, the area under the curve was high for the disseminated intravascular coagulation (DIC) score, the D-dimer value, and the prothrombin time-international normalize ratio (PT-INR). Adequate cut-off values for predicting the outcome were 3 as follows: DIC score, 3 points; D-dimer, 4.2 mg/L; and PT-INR, 1.08. D-dimer, which is a biomarker for thrombosis, is increased in various underlying diseases and predicts a poor outcome.