Clinical Utility of D-Dimer in Monitoring Coagulopathy Among Emergency Department Patients With Sepsis
Abstract
with sepsis, and to explore its prognostic value for disease progression and short-term mortality. Methods: This retrospective study included
186 adult patients with sepsis, diagnosed according to Sepsis-3 criteria, admitted to the emergency department of a tertiary hospital from January 2023 to January 2024. Patients were stratified into three groups based on initial D-dimer levels (<0.5, 0.52.0, >2.0 mg/L). Coagulation
indices, 28-day outcomes, and D-dimer trends within 48 hours were analyzed. Logistic regression was used to identify independent predictors
of mortality. Results: Elevated D-dimer levels were associated with prolonged PT and APTT, lower platelet counts, and higher DIC scores.
The incidence of overt DIC and 28-day mortality increased progressively across D-dimer strata. A D-dimer level >2.0 mg/L was independently associated with increased 28-day mortality (OR=2.87, 95% CI: 1.395.92, P=0.004). Patients with rising D-dimer levels during the first
48 hours had significantly higher rates of organ failure and ICU transfer. Conclusions: D-dimer is a sensitive, rapid, and practical biomarker
for early identification and dynamic assessment of coagulation dysfunction in sepsis. Its integration into emergency protocols may enhance
early risk stratification and support timely clinical intervention.
Keywords
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DOI: http://dx.doi.org/10.70711/mhr.v2i6.6841
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