D-dimer as a predictor of severity and outcome in acute pancreatitis

Joseph A, Harikrishnan CP, Oommen AN, Nair A

Pdf Page Numbers :- 275-280

Alan Joseph¹, Harikrishnan CP^1,*, Ashok Ninan Oommen¹ and Arun Nair¹

¹Department of General Surgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala 680005, India

*Corresponding author: Dr. Harikrishnan CP, Department of General Surgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala 680005, India. Email: alan7joseph@gmail.com

Received 2 August 2024; Revised 16 September 2024; Accepted 21 September 2024; Published 30 September 2024

Citation: Joseph A, Harikrishnan CP, Oommen AN, Nair A. D-dimer as a predictor of severity and outcome in acute pancreatitis. J Med Sci Res. 2024; 12(4):275-280. DOI: http://dx.doi.org/10.17727/JMSR.2024/12-52

Copyright: © 2024 Joseph A et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PDF

Abstract

This prospective observational study, conducted at Jubilee Mission Medical College and Research Institute, Thrissur, explored the role of D-dimer as a predictive marker for the severity and outcomes of acute pancreatitis. A total of 60 patients diagnosed through clinical, biochemical, and imaging criteria were included. The study demonstrated a significant correlation between elevated D-dimer levels and the severity of acute pancreatitis, classified according to the Atlanta criteria. Specifically, D-dimer levels ≥2528 ng/L were strongly associated with severe acute pancreatitis (SAP), while levels ≤1871 ng/L were primarily linked to mild cases. The study identified a D-dimer cutoff value of 1871 ng/L as an effective predictor of complications, with an area under the curve (AUC) of 0.870, yielding 87.5% sensitivity, 83.3% specificity, a positive predictive value of 77.78%, a negative predictive value of 90.90%, and 85% overall accuracy. In addition to severity prediction, the study examined the association between D-dimer levels and the need for supportive interventions. These findings suggest that D-dimer is a valuable biomarker for early risk stratification and could aid in guiding therapeutic decisions in the management of acute pancreatitis. The study emphasizes the importance of conducting larger, multi-center trials to validate these findings and to better understand the prognostic value of D-dimer in diverse clinical settings, potentially enhancing early diagnosis and personalized treatment strategies for patients with acute pancreatitis.

Keywords: acute pancreatitis; D-dimer; severity prediction; clinical outcomes; biomarkers; prognostic marker; coagulation