Plasma D-dimer levels correlate with outcomes in severely septic cardio-surgical patients in the intensive care units

الملخص EN

Background: Severe sepsis and septicemias are lethal conditions following cardiac surgery.

And the purpose of this study is to evaluate the prognostic value of plasma D-dimer levels in septic cardio-surgical patients in the intensive care units.

Methods: A prospective observational study was conducted, and it included one hundred twenty seven septic cardio-surgical patients treated in the intensive care units of tow hospital, Tishreen teaching hospital and Omayad hospital, in Damascus, Syria, from December 2000 to December 2009.

Measurement: Plasma D-dimer was measured using an automated latex assay and recorded on admission and every day until the patient left the ICU.

The relationships between plasma D-dimer and prognostic variables included in the acute physiology and chronic health evaluation II score (APACHE II) and simplify acute physiology score II (SAPSII) were examined, and recorded using univariate and multivariate linear and logistic regression analyses.

And were compared respectively between survivors and non-survivors.

Results: A significant relationship was found between the presence of elevated D-dimer levels and the APACHE II and SAPS II.

Elevated D-dimer levels were associated with severe sepsis.

And D-dimer predictive value for therapy showed an area under the curve of 0.78 (95% confidence interval, 0.71 to 0.81), but D-dimer levels were negative in 12% of the septic patients.

The prognostic value of plasma D-dimer levels was as following: In non-survivors: the D-dimer plasma level mean value was higher than 4 mcg/ ml.

In survivors: the D-dimer value was less than 2 mcg/ ml (p < 0.0001).

Conclusion: The D-dimer plasma levels could be useful for predicting clinical outcome in cardiac surgical patients with severe sepsis.

And it is similar to APACHE II and SAPS II, and D-dimer could be helpful in risk stratification in septic cardiac surgical patients