Plasma d-dimer levels correlate with outcomes in patients with community-acquired pneumonia.

STUDY OBJECTIVES

The aim of this study was to investigate the prognostic value of plasma d-dimer levels in patients with community-acquired pneumonia (CAP).

DESIGN

Prospective observational study.

SETTING

Hospital Lluis Alcanyis of Xativa, Spain.

PATIENTS

Consecutive adult patients admitted to the hospital with CAP from January 2000 to October 2002.

MEASUREMENTS AND RESULTS

A total of 302 patients were included. Plasma d-dimer was measured using an automated latex assay. The relationships between plasma d-dimer and prognostic variables included in the pneumonia severity index (PSI) were examined using univariate and multivariate linear and logistic regression analyses. d-Dimer levels were negative (ie, < 500 ng/mL) in 16.9% of the patients. In nonsurvivors, the d-dimer plasma level mean value was 3,786 ng/mL, while in survivors it was 1,609 ng/mL (p < 0.0001). A significant relationship was found between the presence of elevated d-dimer levels and the PSI and APACHE (acute physiology and chronic health evaluation) II score. Elevated d-dimer levels were associated with radiologic pneumonia extension. The d-dimer predictive value for mechanical ventilation therapy showed an area under the curve of 0.78 (95% confidence interval, 0.71 to 0.81).

CONCLUSIONS

d-Dimer plasma levels could be useful for predicting clinical outcome in patients with CAP.