Diagnosis
D-dimer predicts poor hospitalisation outcomes in patients with antineutrophil cytoplasmic autoantibody-associated vasculitis
J.Y. Pyo1, B. Yoo2, M. Kwon3, W.H. Bae4, S.J. Byun5, S.-W. Lee6, Y.-B. Park7, J.J. Song8
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
- Department of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA.
- Kaiser Permanente-Hawaii Internal Medicine Residency Program, Honolulu, HI, USA.
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, and Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, South Korea. jsksong@yuhs.ac
CER13791
2021 Vol.39, N°2 ,Suppl.129
PI 0094, PF 0100
Diagnosis
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PMID: 33635209 [PubMed]
Received: 09/07/2020
Accepted : 30/11/2020
In Press: 25/02/2021
Published: 19/05/2021
Abstract
OBJECTIVES:
The in-hospital mortality rate among patients with antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) is high. Unfortunately, there is no reliable prognostic biomarker. This study aimed to investigate whether elevated D-dimer levels can predict hospitalisation outcomes among patients with AAV.
METHODS:
We performed a retrospective analysis at a tertiary medical centre in Seoul, South Korea, between 2005 and 2019. Patients with AAV requiring hospitalisation, whose D-dimer levels were available within one week of hospitalisation, were included; patients with known alternative reasons for elevated D-dimer were excluded. Death and intensive care unit requirements were defined as adverse outcomes.
RESULTS:
In total, 61 AAV patients with a total of 100 episodes of hospitalisation were included. Median D-dimer levels were significantly higher in patients with adverse outcomes than in those without adverse outcomes (1.84 vs. 0.42 mg/dL; p=0.006). Consistently, the incidence of the adverse outcomes was significantly higher in the high D-dimer group (≥0.699 mg/dL; n = 40) than in the low D-dimer group (<0.699 mg/dL; n = 60) (35% vs. 10%; p=0.002). Multivariate logistic regression analysis revealed that a high D-dimer level was a significant risk factor for adverse outcomes (hazard ratio, 4.852; 95% confidence interval, 1.320-17.833; p=0.017). Kaplan-Meier survival analysis revealed that the high D-dimer group was associated with more 30-day in-hospital adverse outcomes than the low D-dimer group (p=0.008).
CONCLUSIONS:
High D-dimer levels on admission are significantly associated with adverse outcomes among patients with AAV.
