Prognostic value of d-dimer across Four Populations of Critically Ill Patients (Pulmonary Embolism, Influenza A pneumonia, COVID-19 and Septic Shock) Dataset
In recent years, as a result of the coronavirus disease 2019 (COVID-19) pandemic, d-dimer has gained notoriety for its role as a biomarker of prognosis. The present study aims to evaluate the performance of d-dimer as a prognostic biomarker across four different disease populations of critically ill patients: COVID-19, Influenza A pneumonia, septic shock and pulmonary embolism. We hypothesize that patients with poorer outcomes will have higher d-dimer levels, thus suggesting that elevated d-dimer is a significant risk factor for 90-day mortality. This single-center, observational, prospective study enrolled adult critically ill patients admitted to the Intensive Care Unit (ICU) of a tertiary care university hospital in Spain (Hospital Universitari de Bellvitge), between 2000 and 2021, presenting with pulmonary embolism, severe influenza A pneumonia, severe COVID-19 pneumonia or septic shock with bacteriemia. A total of 124 patients were enrolled in this study: 26 patients with pulmonary embolism, 27 patients with influenza A pneumonia, 27 patients with COVID-19 and 44 patients with septic shock. The data presented include general population characteristics, comorbidities, laboratory and gasometrical results, severity parameters, admission, discharge and last follow-up dates and outcome measures. The four groups have in common early ICU admission due to the severity of the disease. This is reflected in high Sequential Organ Failure Assesment (SOFA) scores and important requirements of both vasopressor support and mechanical ventilation during ICU stay. Additionally, we found remarkably high circulating d-dimer levels across all populations evaluated. These data can be analyzed with univariate, bivariate and multivariate methods.
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The cohort consisted of adult critically ill patients admitted to the ICU of Bellvitge University Hospital, between 2000 and 2021 that met the following requirements: (A) Patients admitted between 2000 and 2020, with pulmonary embolism diagnosed by clinical and radiological criteria; (B) Patients admitted between 2009 and 2016, with influenza A pneumonia diagnosed by clinical, radiological and microbiological criteria; (C) Patients admitted between 2020 and 2022, with severe COVID-19 pneumonia and acute kidney injury (AKI) (assessed using Kidney Disease: Improving Global Outcomes criteria within 24 hours after enrollment) in its most severe stage (stage 3); (D) Patients admitted between 2013 and 2015, with septic shock, bacteremia and AKI requiring continuous renal replacement therapy (CRRT). General population characteristics, comorbidities, laboratory and gasometrical results, severity parameters, admission, discharge and last follow-up dates and outcome measures were evaluated through hospital chart review and Catalunya’s shared health record (HC3) review. D-dimer mass concentration was determined through latex particle-enhanced turbidimetric immunoassay performed on the analyzer ACLTOP 750LAS from Instrumentation Laboratory (Bedford, MA, USA). The reagent used was HEMOSIL DIMER-D HS (ref. 00020007700), from the same company (Instrumentation Laboratory).