Predictive value of elevated serum D‑dimer for short‑term prognosis in patients with HBV‑related acute‑on‑chronic liver failure
Affiliations: Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
- Published online on: May 30, 2022 https://doi.org/10.3892/etm.2022.11399
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To study the predictive value of elevated serum D‑dimer on short‑term prognosis in patients with hepatitis B virus‑related acute‑on‑chronic liver failure (HBV‑ACLF) and the correlation between serum D‑dimer level and the clinical data of these patients, a single center retrospective study was conducted to collect the clinical data and 28 and 90‑day survival rates of 201 patients. Logistic regression analysis and receiver operating characteristic curves were used to determine the factors affecting short‑term prognosis. A Kaplan‑Meier curve was used to compare the difference in survival rate between the two groups with elevated D‑dimer and normal D‑dimer levels. Correlation analysis was used to determine the correlation between serum D‑dimer level and the clinical data of the patients. The results showed that international normalized ratio (INR) >2.3 and age >53 years were independent risk factors affecting the 28‑day survival rate of the patients (P<0.05). INR >2.3, serum total bilirubin >358.2 µmol/l, age >49 years and elevated serum D‑dimer (>550 ng/ml) were independent risk factors affecting the 90‑day survival rate of the patients (P<0.05). There were significant differences in the 90‑day survival rate and the survival time between the patients with elevated D‑dimer and normal D‑dimer levels (P<0.05). Serum D‑dimer level was positively associated with age, combined spontaneous peritonitis, albumin, INR and the model for end‑stage liver disease sodium (MELD‑Na) scores, and negatively associated with male sex, red blood cell count, and serum sodium and fibrinogen levels. It was concluded that elevated serum D‑dimer (>550 ng/ml) is an independent risk factor affecting the 90‑day survival rate of patients with HBV‑ACLF. The 90‑day survival rate and the survival time of patients with HBV‑ACLF and elevated D‑dimer levels are significantly lower than those with normal D‑dimer levels. Overall, serum D‑dimer is associated the short‑term prognosis of patients with HBV‑ACLF, and the detection of serum D‑dimer level at admission can help predict the short‑term prognosis of patients with HBV‑ACLF, especially the 90‑day prognosis.