Prognostic value of baseline plasma D-dimer levels in sepsis: a prospective cohort study
Background: Plasma D-dimer, a fibrin degradation product, reflects coagulation activation and is often elevated in critically ill patients. Its prognostic significance in sepsis, particularly for short-term outcomes, remains unclear. Methods: In this prospective cohort study, we enrolled 175 adult I...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
|
| Series: | Practical Laboratory Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352551725000514 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849222550976987136 |
|---|---|
| author | Xiaoxiao Qu Shishi Wang Xuanmei Ye Guosong Jiang Mihereguli Kuerban Qipeng Xie |
| author_facet | Xiaoxiao Qu Shishi Wang Xuanmei Ye Guosong Jiang Mihereguli Kuerban Qipeng Xie |
| author_sort | Xiaoxiao Qu |
| collection | DOAJ |
| description | Background: Plasma D-dimer, a fibrin degradation product, reflects coagulation activation and is often elevated in critically ill patients. Its prognostic significance in sepsis, particularly for short-term outcomes, remains unclear. Methods: In this prospective cohort study, we enrolled 175 adult ICU patients with sepsis (Sepsis-3 criteria) from March 2024 to February 2025. Plasma D-dimer levels were measured at ICU admission and daily for five days. D-dimer levels were categorized into quartiles. The primary outcome was 30-day all-cause mortality; secondary outcome was in-hospital septic shock. Associations were analyzed using Cox regression, Kaplan–Meier analysis, and subgroup analysis. Results: Elevated admission D-dimer levels were significantly associated with increased risks of 30-day mortality and septic shock. Each 1 μg/mL increase in D-dimer was linked to a 6 % higher mortality risk (HR = 1.06; 95 % CI: 1.02–1.11; P = 0.008) and an 8 % higher septic shock risk (HR = 1.08; 95 % CI: 1.03–1.12; P < 0.001), after adjusting for confounders. Patients in the highest quartile had the worst outcomes. A significant interaction with serum amyloid A (SAA) was observed for mortality (P = 0.043), but not for septic shock. Conclusion: Baseline plasma D-dimer levels independently predict 30-day mortality and septic shock in sepsis. D-dimer may serve as a valuable early biomarker for risk stratification in sepsis management. |
| format | Article |
| id | doaj-art-0dea0e4b710d4f67bb7b8450ee036f44 |
| institution | Kabale University |
| issn | 2352-5517 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Practical Laboratory Medicine |
| spelling | doaj-art-0dea0e4b710d4f67bb7b8450ee036f442025-08-26T04:14:24ZengElsevierPractical Laboratory Medicine2352-55172025-09-0146e0049810.1016/j.plabm.2025.e00498Prognostic value of baseline plasma D-dimer levels in sepsis: a prospective cohort studyXiaoxiao Qu0Shishi Wang1Xuanmei Ye2Guosong Jiang3Mihereguli Kuerban4Qipeng Xie5Department of Clinical Laboratory, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, ChinaDepartment of Clinical Laboratory, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, ChinaDepartment of Clinical Laboratory, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, ChinaDepartment of Pulmonary and Critical Care Medicine, The 1st People's Hospital of Zhaotong City&The Zhaotong Affiliated Hospital of Kunming Medical University, Zhaotong, 657000, Yunnan, ChinaSchool of Medical Technology, XinJiang HeTian College, Hetian, Xinjiang, 848000, ChinaDepartment of Clinical Laboratory, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China; Corresponding author.Background: Plasma D-dimer, a fibrin degradation product, reflects coagulation activation and is often elevated in critically ill patients. Its prognostic significance in sepsis, particularly for short-term outcomes, remains unclear. Methods: In this prospective cohort study, we enrolled 175 adult ICU patients with sepsis (Sepsis-3 criteria) from March 2024 to February 2025. Plasma D-dimer levels were measured at ICU admission and daily for five days. D-dimer levels were categorized into quartiles. The primary outcome was 30-day all-cause mortality; secondary outcome was in-hospital septic shock. Associations were analyzed using Cox regression, Kaplan–Meier analysis, and subgroup analysis. Results: Elevated admission D-dimer levels were significantly associated with increased risks of 30-day mortality and septic shock. Each 1 μg/mL increase in D-dimer was linked to a 6 % higher mortality risk (HR = 1.06; 95 % CI: 1.02–1.11; P = 0.008) and an 8 % higher septic shock risk (HR = 1.08; 95 % CI: 1.03–1.12; P < 0.001), after adjusting for confounders. Patients in the highest quartile had the worst outcomes. A significant interaction with serum amyloid A (SAA) was observed for mortality (P = 0.043), but not for septic shock. Conclusion: Baseline plasma D-dimer levels independently predict 30-day mortality and septic shock in sepsis. D-dimer may serve as a valuable early biomarker for risk stratification in sepsis management.http://www.sciencedirect.com/science/article/pii/S2352551725000514SepsisD-dimerAll-cause mortalitySeptic shockPrognostic biomarkerIntensive care unit |
| spellingShingle | Xiaoxiao Qu Shishi Wang Xuanmei Ye Guosong Jiang Mihereguli Kuerban Qipeng Xie Prognostic value of baseline plasma D-dimer levels in sepsis: a prospective cohort study Practical Laboratory Medicine Sepsis D-dimer All-cause mortality Septic shock Prognostic biomarker Intensive care unit |
| title | Prognostic value of baseline plasma D-dimer levels in sepsis: a prospective cohort study |
| title_full | Prognostic value of baseline plasma D-dimer levels in sepsis: a prospective cohort study |
| title_fullStr | Prognostic value of baseline plasma D-dimer levels in sepsis: a prospective cohort study |
| title_full_unstemmed | Prognostic value of baseline plasma D-dimer levels in sepsis: a prospective cohort study |
| title_short | Prognostic value of baseline plasma D-dimer levels in sepsis: a prospective cohort study |
| title_sort | prognostic value of baseline plasma d dimer levels in sepsis a prospective cohort study |
| topic | Sepsis D-dimer All-cause mortality Septic shock Prognostic biomarker Intensive care unit |
| url | http://www.sciencedirect.com/science/article/pii/S2352551725000514 |
| work_keys_str_mv | AT xiaoxiaoqu prognosticvalueofbaselineplasmaddimerlevelsinsepsisaprospectivecohortstudy AT shishiwang prognosticvalueofbaselineplasmaddimerlevelsinsepsisaprospectivecohortstudy AT xuanmeiye prognosticvalueofbaselineplasmaddimerlevelsinsepsisaprospectivecohortstudy AT guosongjiang prognosticvalueofbaselineplasmaddimerlevelsinsepsisaprospectivecohortstudy AT miheregulikuerban prognosticvalueofbaselineplasmaddimerlevelsinsepsisaprospectivecohortstudy AT qipengxie prognosticvalueofbaselineplasmaddimerlevelsinsepsisaprospectivecohortstudy |