Document Detail


D-dimer as a predictor of the need for laparotomy in patients with unclear non-traumatic acute abdomen. A preliminary study.
MedLine Citation:
PMID:  19378433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The acute onset of intense abdominal pain requires rapid evaluation, and since D-dimer level is reported to be useful in the diagnosis of patients with suspected acute superior mesenteric artery occlusion, our aim was to evaluate the value of D-dimer testing in the diagnosis of acute surgical abdomen with no precise diagnosis. MATERIAL AND METHODS: Between July 2004 and June 2006, 93 patients with acute abdomen who required surgical exploration without precise diagnosis were admitted to this prospective clinical study. After surgery, the patients were divided into two groups: group 1 (n=52), patients who needed immediate laparotomy, and group 2 (n=41), patients without the need for laparotomy. Blood samples were taken to analyse D-dimer, white blood cell count and pH level. P-values of <0.05 were considered statistically significant. RESULTS: There was a positive correlation between the plasma D-dimer level and leucocyte count. Leucocyte counts > 16,800/mm3 (p < 0.01) and D-dimer levels >4.7 microg FEU/mL were more sensitive (p < 0.001). Sensitivity was 97.6% and specificity 61.5% for D-dimer level, and 82.9% and 42.3%, respectively, for leucocyte count. Metabolic acidosis at admission was the most important factor for mortality (p < 0.001). CONCLUSIONS: In a patient with acute abdomen without precise diagnosis, a D-dimer level above the cut-off value (4.7 microg fibrinogen equivalent units/mL) may be an indicator with high sensitivity for surgical pathology requiring laparotomy.
Authors:
Hizir Akyildiz; Alper Akcan; Ahmet Oztürk; Erdogan Sozuer; Can Kucuk; Akif Yucel
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Scandinavian journal of clinical and laboratory investigation     Volume:  68     ISSN:  0036-5513     ISO Abbreviation:  Scand. J. Clin. Lab. Invest.     Publication Date:  2008  
Date Detail:
Created Date:  2009-04-20     Completed Date:  2009-05-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404375     Medline TA:  Scand J Clin Lab Invest     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  612-7     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Erciyes University, Kayseri, Turkey. hyakyildiz@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdomen, Acute / diagnosis,  surgery*
Acidosis / diagnosis
Aged
Atrial Fibrillation / diagnosis
Female
Fibrin Fibrinogen Degradation Products / analysis*
Humans
Hydrogen-Ion Concentration
Laparotomy / utilization*
Leukocyte Count
Male
Mesenteric Vascular Occlusion / diagnosis
Middle Aged
Prospective Studies
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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