THE PROGNOSTIC AND DIAGNOSTIC VALUE OF PLASMA D-DIMER LEVELS IN ELDERLY PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA


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Bulut S., Çelik D., Karamanli H.

Turk Geriatri Dergisi, vol.25, no.2, pp.262-273, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 2
  • Publication Date: 2022
  • Doi Number: 10.31086/tjgeri.2022.284
  • Journal Name: Turk Geriatri Dergisi
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, EMBASE, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.262-273
  • Keywords: Pneumonia, Aged, Severity of Illness Index, INTENSIVE-CARE-UNIT, PULMONARY THROMBOEMBOLISM, DIFFERENTIAL-DIAGNOSIS, SEVERITY, MORTALITY, EMBOLISM, BURDEN, ADULTS, COPD
  • Ataturk University Affiliated: No

Abstract

© 2022, Geriatrics Society. All rights reserved.Introduction: This study aimed to investigate the relationship between community-acquired pneumonia severity and D-dimer levels in individuals older than 65. We also investigated the relationship between D-dimer levels and the adverse outcomes in patients with community-acquired pneumonia after excluding all other potential causes of high D-dimer levels. Materials and Methods: Patients older than 65 who were admitted to the emergency service of a tertiary chest diseases training and research hospital between January 1, 2019, and October 1, 2020, were evaluated. Patients who met the diagnostic criteria for community-acquired pneumonia were included. In clinically questionable cases of coexistence of pulmonary embolism and community-acquired pneumonia, D-dimer levels and pulmonary computerize tomography angiography or ventilation-perfusion scintigraphy were examined. Confirmed pulmonary embolism patients were excluded. Of 4,608 patients evaluated, 82 had a diagnosis of community-acquired pneumonia with no comorbidity. The severity of these cases was determined with the CURB-65 score and pneumonia severity index score. Results: The mean age of the cases was 73.83±6.67 years, while their gender was predominantly male (n=51, 62.2%). A statistically significant correlation was found between D-dimer levels and both the CURB-65 and pneumonia severity index high-risk groups (p=0.001 and p=0.001, respectively). The adverse outcomes were statistically higher in both the CURB-65 and pneumonia severity index high-risk groups (p<0.001). Conclusions: D-Dimer is an easy-to-interpret, fast, inexpensive, highly sensitive, and simple test widely used in clinics. We found that high levels of D-dimer can predict the need for intensive care unit care, disease severity, and mortality of elderly community-acquired pneumonia patients.