Elevated D-dimer is associated with increased 28-day mortality in acute-on-chronic liver failure in China: a retrospective study.
BMC Gastroenterol
; 19(1): 20, 2019 Jan 31.
Article
em En
| MEDLINE
| ID: mdl-30704397
ABSTRACT
BACKGROUND:
Acute-on-chronic liver failure (ACLF) is a syndrome characterized by profound disrupted coagulation and fibrinolysis. Fibrinolytic marker D-dimer is increased in critically ill patients with cirrhosis which is associated with poorer prognosis. We aim to determine the potential association of D-dimer with the 28-day mortality in ACLF patients.METHODS:
In a single center retrospective study performed in China, we collected data of 115 patients with ACLF from October 1, 2012 to December 31, 2016. We investigated correlations between D-dimer and other laboratory tests and prognostic scores. The relationship between D-dimer and 28-day mortality was explored by smoothing plot with an adjustment for potential confounders. Logistic regression analyses with crude and adjusted models were performed to explore the association of D-dimer with 28-day mortality in ACLF patients.RESULTS:
In ACLF patients, D-dimer at admission was correlated with all prognostic scores (MELD-Na r = 0.385, P < 0.001; CLIF-C ADs r = 0.443, P < 0.001; CLIF-C ACLFs r = 0.375, P < 0.001). A nonlinear relation between D-dimer and 28-day mortality was found with a turning point at 6.5 mg/L FEU. D-dimer level was independently associated with 28-day mortality with an adjusted odds ratio of [1.4 (1.0-1.9), P = 0.030] as continuous variable and [10.3 (1.3, 81.5), P = 0.028] as a classified variable with the cut-off of 6.5 mg/L FEU. An elevated D-dimer within the following 10 days also tended to be associated with higher risk of 28-day mortality [OR 27.5 (0.9, 814.9), P = 0.055].CONCLUSIONS:
Elevated D-dimer levels was associated with increased risk of 28-day mortality in patients with ACLF in China.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Produtos de Degradação da Fibrina e do Fibrinogênio
/
Insuficiência Hepática Crônica Agudizada
Tipo de estudo:
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article