1 Role of D-dimer in Predicting Severity and Mortality of Community-acquired Pneumonia

Abstract : Introduction: Coagulation disturbances are one of the markers of systemic inflammation. Aim: To evaluate the role of D-dimer (DD) in predicting severity and mortality of hospitalized patients with community-acquired pneumonia. Material and Methods:143 CAP patients hospitalized in the Clinic of Pneumology and Phthisiatrics at “Saint Marina” University Hospital were retrospectively studied. D-dimer was measured on admission by latex-enhanced immunoturbidimetric method with reference value of 0,232mg/L. The severity of CAP was determined by PSI, CURB-65 and IDSA/ATS criteria. Results: Patients were on mean age 62.12±15.54 years, 59.4% - male. Elevated levels of D-dimer were found in 86.70% of the patients. The mean DD in non-survivors was significantly higher than in survivors (2.19±2.01mg/L vs. 1.28±1.46mg/L, р<0.05). DD increased significantly with increasing the severity group according to PSI, CURB-65 and IDSA/ATS criteria, but the correlation coefficients were weak (r=0.25; r=0.23; r=0.22 resp., p<0.001). DD>1mg/L increased the risk for in-hospital mortality with OR 4.25 (1.48-12.14; p<0.01). Conclusion: D-dimer is able to predict severity and outcome of CAP.

Keyword : CAP, D-dimer, severity, mortality