scholarly journals Diagnostic Efficacy of D-Dimer Test in Patients Suffering from Disseminated Intravascular Coagulation (DIC) Attending in Tertiary Care Hospital at Patna

Author(s):  
Dr Kamla Kumari ◽  
Author(s):  
Soibam Pahel Meitei ◽  
Sudheer Tale ◽  
Arjun Kumar Negi ◽  
Ruchi Dua ◽  
Rohit Walia ◽  
...  

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dimer above the age adjusted cut-off underwent computerised tomography pulmonary angiography (CTPA).  Results were analysed using SPSS version 23.  Sixteen (10.3%) patients had VTE, 15 (93.75%) of them being cases of isolated PE. Female gender, higher cumulative past exposure to corticosteroid, higher alveolar-arterial gradient, right ventricular dysfunction, and higher mean pulmonary artery pressure were associated with increased risk for VTE. The prevalence of VTE in AECOPD in this study among an Indian population is higher than among other Asians, but lower than among the Blacks, the Caucasians and the Middle-East ethnicities. Since a vast majority of VTE presents as PE without DVT in the setting of AECOPD, the absence of deep vein thrombosis of lower limbs does not rule PE in the setting.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Diana J. Kelm ◽  
Juan Carlos Valerio-Rojas ◽  
Javier Cabello-Garza ◽  
Ognjen Gajic ◽  
Rodrigo Cartin-Ceba

Purpose. The goal of this study was to identify potential clinical predictors for the development of disseminated intravascular coagulation (DIC) in patients with septic shock. Material and Methods. We performed a retrospective analysis of a cohort of adult (>18 years of age) patients with septic shock admitted to a medical ICU in a tertiary care hospital from July 2005 until September 2007. A multivariate logistic regression model was used to determine the association of risk factors with overt DIC. Results. In this study, a total of 390 patients with septic shock were analyzed, of whom 66 (17%) developed overt DIC. Hospital mortality was significantly greater in patients who developed overt DIC (68% versus 38%, P<0.001). A delay in the timing of antibiotics was associated with an increased risk of the development of overt DIC (P<0.001). Patients on antiplatelet therapy prior to hospital admission and who that received adequate early goal-directed therapy (EGDT) were associated with a decreased risk of overt DIC (P<0.001). Conclusions. In our cohort of patients with septic shock, there was a risk reduction for overt DIC in patients on antiplatelet therapy and adequate EGDT, while there was an increased risk of DIC with antibiotic delay.


2021 ◽  
pp. 25-28
Author(s):  
Pramodh Kumar ◽  
Konduru Aneesha ◽  
Ch. Radhika ◽  
Elaya Kumar ◽  
R. Srinivasan

AIM: To correlate between CT chest severity score in COVID 19 patients with Clinical [SpO2, RR, PaO2/FiO2] and Biochemical parameters [NLR ratio, CRP, D- Dimer values]. METHODS: A Retrospective, observational study was conducted in a tertiary care hospital in Kanchipuram, Tamil Nadu. 110 patients were admitted to the hospital with COVID 19 [RT PCR swab for COVID 19 positive and radiologically positive] between March 2021 to June 2021. The patient was clinically, radiologically, and biochemically evaluated. CT chest severity score was used to differentiate the patients into mild, moderate, and severe groups. The relationship between CT Severity score and Clinical parameters such as SpO2, RR, PaO2/FiO2 and Biochemical markers [ NLR ratio, CRP, D-Dimer] were studied. RESULTS: CT chest severity score was found to be positively correlated with decreased SpO2 levels, decreased PaO2/ FiO2, increased RR and elevated NLR ratio, D Dimer and CRP levels(P < 0.001). CONCLUSION: The 25 CT Severity score scores well with the Clinical parameters and biochemical markers. Our data suggest that CT Chest Severity Score correlates well with clinical parameters and biochemical markers.


2021 ◽  
Vol 10 (12) ◽  
pp. 4478
Author(s):  
Kirubhakaran Kanakaraju ◽  
MoogaambigaS Pandiyan ◽  
RangabashyamS Ranganathan ◽  
Arunkumar Asokan

2021 ◽  
Vol 9 (2) ◽  
pp. 80-84
Author(s):  
Dr. Manasa. S ◽  
◽  
Dr. Venkatesh Vikram H. C ◽  

Introduction: Pro-thrombotic changes are stimulated by Corona Virus as it has an affinity forendothelium and lung structures and this may explain its association with thrombotic events,reduction of pulmonary gas exchange, respiratory distress, and death. D-dimer is a specific markerof the breakdown of a fibrin clot and has been used as a diagnostic and prognostic marker in VTEand other coagulation disorders. Objectives: The objective of this study was to assess thecorrelation of the D-Dimer levels and disease severity among COVID-19 patients. Materials andmethods: This is a retrospective study done over 6 months from July 2020 to December 2020 in atertiary care hospital in Bangalore. All the COVID- 19 positive cases who were admitted to ourhospital were audited regarding the D-dimer levels during admission and the course of thetreatment. Results: Coagulation disorder occurred at the early stage of COVID-19 infection, with1066 (57.7%) patients having increased D-dimer levels. Out of 1846 COVID 19 patients 106(5.7%)patients died due to complications. 106 patients who deceased, all the patients had anincreased D dimer value either in the first lab test or in the consecutive tests. Among 106 patients56(52.8%) patients had increased D-dimer at the first lab test, 32 (30.1%) had D-dimer increasedat the second and 18(16.98%) in third lab tests. The increased D-dimer levels were closelyassociated with the progression of the disease and also the changes in the CT imaging. Conclusion:The increase in D-Dimer levels also increased the complications in the COVID-19 patient. So it isnecessary to continuously monitor D-dimer levels and labelled anticoagulation as management toolsfor COVID-19 disease to prevent complications and reduce interventions.


Author(s):  
Avick Nag ◽  
Soumyadeep Ghosh ◽  
Anushree Pal ◽  
Ankan Saha ◽  
Sanjay Kumar Mandal

Introduction: The disease caused by Coronavirus (COVID-19), is now pandemic all over the world including India. There are different manifestations of the disease from asymptomatic and mild to severe form. Clinical severity varies from country to country. This study was conducted to document different clinical and biochemical profiles in this Tertiary Care Hospital of Kolkata. Aim: The study was done to observe and to compare the clinical and biochemical profile in asymptomatic to mild and moderate to severe symptomatic patients. Materials and Methods: This was an observational study conducted in Medical College, Kolkata, West Bengal, India. The study was conducted from June 2019 to mid-August 2019. Total 573 Real Time Polymerase Chain Reaction (RT PCR) positive COVID patients were included in this study. All patients were examined and investigated with blood parameters. Patients were divided into two groups (Group A-asymptomatic and mild symptoms and Group B moderate and severe symptoms) clinically. Statistical calculators like Statistical Package for Social Sciences (SPSS) and Soccalculator were used and different biochemical parameters were analysed using Chi-square, unpaired T-test to find out significance among these two groups. Results: Among 573 patients, 222 were in group A and 351 were in group B. Fever was the most common presenting feature (69.6%) followed by dry cough and shortness of breath. Other features were malaise/fatigability, diarrhoea and anosmia. Among the co-morbidities hypertension and diabetes were significantly different between the two groups. Among the biochemical parameters Neutrophil-Lymphocyte Ratio (NLR), C-Reactive Protein (CPR), D-dimer, Prothrombin time, Serum Glutamic Oxaloacetic Transaminase (SGOT), Serum Glutamic Pyruvic Transaminase (SGPT) were significantly different between the two groups. Conclusion: In a tertiary care hospital of Kolkata, fever is the most common presentation followed by dry cough and fatigability in COVID patients. Diabetes and hypertension are the common co morbidities. CRP, NLR, D-dimer, prothrombin time, SGOT and SGPT should be monitored to differentiate between mild and severe cases.


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 268-273
Author(s):  
Archana Bhat ◽  
Don Gregory Mascarenhas ◽  
J Manjunath ◽  
Anand Kumar R ◽  
Sucharitha Suresh ◽  
...  

Introduction and Aim:A novel beta-coronavirus emerged in Wuhan, China during the early December 2019 and spread globally. The clinical signs and symptoms and the disease severity in people infected with COVID-19 can be varied. The present study was conducted to study the biomarker profile and their association with disease severity in COVID-19.   Materials and Methods:This was a single-centre Cohort study of data regarding epidemiological, clinical and biomarker parameters, and outcome of COVID-19 patients admitted in a tertiary care hospital in South India. CDC guidelines were followed for assessing disease severity.   Results:A total of 336 COVID-19 patients were admitted during the study period. Of these 16 were excluded and 320 cases were analysed. Mean age of patients was 44.82 years. A male predominance was observed. Diabetes mellitus was the most common co-morbidity. Asymptomatic, Mild, moderate, severe and critical disease was seen in 15%, 52.5%, 20.3%, 6.3% and 5.9% patients respectively. ICU care was required in 15.3%. Overall mortality was 5.3%. The mean NLR, ALC, CRP, LCR, LDH, Ferritin and D-dimer in the severe group vs non-severe groupwere19.03 vs 4.2, 1025cells/cumm vs 1740cells/cumm, 185.8mg/L vs 31.7mg/L, 17.1 vs 996.3, 552.8IU/L vs 252.7IU/L, 2531.9ng/ml vs 414.1ng/ml and 2245.5ng/ml vs 339.4ng/ml respectively.   Conclusion:An increased NLR, CRP, LDH, Ferritin and D-dimer and a reduced ALC and LCR are significantly associated with disease severity, need for ICU and mortality. These biomarkers will be useful adjunct to clinical assessment in better categorising and management of COVID-19 patients.


2021 ◽  
Vol 8 (3) ◽  
pp. 226-229
Author(s):  
G Rajeswari ◽  
P Satya Gopal ◽  
G.B.V.V.S.V Prasad

This study was conducted on covid 19 patients who admitted in various wards in tertiary care centre (Government general hospital, Kakinada) E.G, Dt, Andhra Pradesh, from the 1st November 2020 to 15th January 2021 before Immunization. And divided in to two groups male and female cases. This study involves estimation of Biochemical profile in all the admitted patients to predict the severity of the covid 19 disease at the time of admission in to the Hospital. To analyse and estimate the serum inflammatory markers like D dimer, Ferritin, C-Reactive Protein, LFT and RFT in Covid 19 patients and evaluate the relationship of inflammatory marker se D-Dimer with other inflammatory markers like Ferritin, CRP and biochemical markers like Creatinine and liver enzymes (OT, PT). We retrospectively analysed the Clinical features and lab parameters of 393 cases of Covid-19 admitted to tertiary care hospital GGH Kakinada. Plasma d dimer, serum CRP and ferritin were significantly raised in total covid 19 patients and more increased in males when compared with females. Biochemical parameters like creatinine and liver enzymes also elevated in total cases and more increased in males as compared with females suggest organ dysfunction and systemic inflammation. The most typical finding in patients with COVID-19 coagulopathy is an increased D dimer concentration, and the relationship between D-dimer levels and the other markers of inflammation like Ferritin, CRP in COVID-19 shows disease progression. We conclude that biochemical monitoring of Covid-19 patients helps in identifying critically ill patients even earlier, aiming to reduce mortality and improve the recovery rate.


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