Ascitic and plasma D-dimer as a prognostic biomarker for predicting hospital mortality in cirrhotic patients with spontaneous bacterial peritonitis

Ahmed Lotfy AbdEl-hady, Ruwida Yahia; Mohamed Abdelaleem, Ahmed Ali; Shaban, Fatma Mokhtar

doi:10.21608/mjmr.2023.181790.1247

Ascitic and plasma D-dimer as a prognostic biomarker for predicting hospital mortality in cirrhotic patients with spontaneous bacterial peritonitis

Document Type : Review Article

Authors

¹ Internal medicine department faculty of medicine minia university

² internal medicine department faculty of medicine minia university

³ internal medicine minia university

10.21608/mjmr.2023.181790.1247

Abstract

Background: D-dimer is a specific test for the presence of fibrinolysis. Its abnormality reflects the activation of coagulation and fibrinolysis systems in vivo . chronic liver disease is associated with disordered hemostasis, it could be associated not only with defects in coagulation but also of clot lysis. Estimation of D –Dimer provide insight into possible derangements in the fibrinolytic pathway.

Objective: Aim of this study was, (1) Evaluate serum D-dimer in cirrhotic patients with and without ascites to assess the relationship between ascites and the hyperfibrinolytic state in liver cirrhosis. Additionally, we assessed the effect of SBP on serum and ascitic fluid concentration of D-dimer.

(2) Role of D-dimer in predicting the in-hospital mortality in liver cirrhosis.

Patients & Methods: This study is a prospective study. It was conducted on 60 patients from the Department of Internal Medicine in Minia University hospital included patients hospitalised with decompensated liver cirrhosis and ascites This study was conducted on four groups, where full history taken, clinical examination, biochemical tests, ultrasonography .

Results: There is diagnostic performance of serum and ascitic D dimer in diagnosing of SBP, and there were significant role of serum D dimer in prediction of 3 months mortality based on MELD score.

Conclusion: D-dimer good diagnostic performance for SBP among patients with liver cirrhosis.

D dimer levels of liver cirrhosis patients were found significantly associated with the degree of liver dysfunction. Furthermore, higher D dimer levels predicted an increased risk of in hospital mortality as a result of liver cirrhosis.

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