Af. Shorr et al., D-dimer assay predicts mortality in critically ill patients without disseminated intravascular coagulation or venous thromboembolic disease, INTEN CAR M, 25(2), 1999, pp. 207-210
Objective: To determine if D-dimer predicts outcomes in critically ill pati
ents.
Design: Observational, cohort study.
Setting: Medical intensive care unit (MICU) of a tertiary care hospital. Pa
tients and participants: Seventy-four patients consecutively admitted to th
e MICU.
Interventions: D-dimer was measured by latex agglutination within 12 h of a
dmission to the MICU.
Measurements and results: Of the study population, 43.2% had positive D-dim
ers. The in-hospital mortality rate in D-dimer positive patients was 28.1%
as compared to 7.1% in D-dimer negative subjects (p = 0.024). D-dimer posit
ive patients had significantly greater frequencies of venous thromboses (21
.9% vs 4.8%, p = 0.035).
Conclusions: The D-dimer assay identifies patients at increased risk for mo
rtality and may be a more sensitive test to determine the presence of under
lying microvascular pathology in critically ill patients. A positive D-dime
r at admission to the MICU is associated with an increased risk for the lat
er development of a venous thromboembolic event (VTE).