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> Estimation of Admission D-dimer Cut-off Value to Predict Venous Thrombotic Events in Hospitalized COVID-19 Patients: Analysis of the SEMI-COVID-19 Registry
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Estimation of Admission D-dimer Cut-off Value to Predict Venous Thrombotic Events in Hospitalized COVID-19 Patients: Analysis of the SEMI-COVID-19 Registry
García-Cervera, Carles
;
Giner-Galvañ, Vicente
;
Wikman-Jorgensen, Philip
;
Laureiro, Jaime
;
Rubio-Rivas, Manuel
;
Gurjian Arena, Anthony
;
Arnalich-Fernandez, Francisco
;
Beato Pérez, José Luis
;
Vargas Núñez, Juan Antonio
;
González Igual, Jesús Javier
(Universidad de Zaragoza)
;
Díez-Manglano, Jesús
(Universidad de Zaragoza)
;
Méndez Bailón, Manuel
;
García Blanco, María José
;
Freire Castro, Santiago J.
;
Aranda Lobo, Judit
;
Manzano, Luis
;
Magallanes Gamboa, Jeffrey Oskar
;
Arribas Pérez, Luis
;
González Moraleja, Julio
;
Calderón Hernaiz, Ruth
;
García Alegría, Javier
;
González Noya, Amara
;
Gómez Huelgas, Ricardo
;
Lumbreras Bermejo, Carlos
;
Antón Santos, Juan Miguel
Resumen:
Background: Venous thrombotic events (VTE) are frequent in COVID-19, and elevated plasma D-dimer (pDd) and dyspnea are common in both entities. Objective: To determine the admission pDd cut-off value associated with in-hospital VTE in patients with COVID-19. Methods: Multicenter, retrospective study analyzing the at-admission pDd cut-off value to predict VTE and anticoagulation intensity along hospitalization due to COVID-19. Results: Among 9386 patients, 2.2% had VTE: 1.6% pulmonary embolism (PE), 0.4% deep vein thrombosis (DVT), and 0.2% both. Those with VTE had a higher prevalence of tachypnea (42.9% vs. 31.1%; p = 0.0005), basal O2 saturation <93% (45.4% vs. 33.1%; p = 0.0003), higher at admission pDd (median [IQR]: 1.4 [0.6–5.5] vs. 0.6 [0.4–1.2] µg/ml; p < 0.0001) and platelet count (median [IQR]: 208 [158–289] vs. 189 [148–245] platelets × 109/L; p = 0.0013). A pDd cut-off of 1.1 µg/ml showed specificity 72%, sensitivity 49%, positive predictive value (PPV) 4%, and negative predictive value (NPV) 99% for in-hospital VTE. A cut-off value of 4.7 µg/ml showed specificity of 95%, sensitivity of 27%, PPV of 9%, and NPV of 98%. Overall mortality was proportional to pDd value, with the lowest incidence for each pDd category depending on anticoagulation intensity: 26.3% for those with pDd >1.0 µg/ml treated with prophylactic dose (p < 0.0001), 28.8% for pDd for patients with pDd >2.0 µg/ml treated with intermediate dose (p = 0.0001), and 31.3% for those with pDd >3.0 µg/ml and full anticoagulation (p = 0.0183). Conclusions: In hospitalized patients with COVID-19, a pDd value greater than 3.0 µg/ml can be considered to screen VTE and to consider full-dose anticoagulation. © 2021, Society of General Internal Medicine.
Idioma:
Inglés
DOI:
10.1007/s11606-021-07017-8
Año:
2021
Publicado en:
JOURNAL OF GENERAL INTERNAL MEDICINE
36, 11 (2021), 3478-3486
ISSN:
0884-8734
Factor impacto JCR:
6.473 (2021)
Categ. JCR:
MEDICINE, GENERAL & INTERNAL
rank: 31 / 172 = 0.18
(2021)
- Q1
- T1
Categ. JCR:
HEALTH CARE SCIENCES & SERVICES
rank: 11 / 109 = 0.101
(2021)
- Q1
- T1
Factor impacto CITESCORE:
5.7 -
Medicine
(Q1)
Factor impacto SCIMAGO:
1.537 -
Internal Medicine
(Q1)
Tipo y forma:
Article (Published version)
Área (Departamento):
Area Medicina
(
Dpto. Medicina, Psiqu. y Derm.
)
Exportado de SIDERAL (2024-02-12-14:15:26)
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Notice créée le 2022-02-10, modifiée le 2024-02-12
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