A value of D-dimer in acute arterial mesenteric ischemia

In acute arterial occlusive mesenteric ischemia (AOMI), baseline serum D-dimer levels hold significant prognostic value. The study found that elevated D-dimer levels were strongly associated with both short-term (30-day) and long-term (1-year) mortality. Non-survivors had markedly higher D-dimer levels compared to survivors (4.8 mg/L vs. 1.5 mg/L, p < 0.001). Elevated D-dimer reflects underlying hypercoagulability, endothelial dysfunction, and systemic inflammation, which are characteristic of severe disease progression in AOMI.

Optimal cutoff values for D-dimer were identified to predict mortality outcomes effectively. For 30-day mortality, the cutoff was 0.578 mg/L (82.8% sensitivity, 75.0% specificity), while for 1-year mortality, the threshold was 0.516 mg/L (90.9% sensitivity, 60.7% specificity). Patients with D-dimer levels above these cutoffs had significantly lower survival probabilities, confirmed through Kaplan-Meier survival analysis.

These findings suggest that measuring D-dimer within 24 hours of diagnosis can alert clinicians to critical disease severity, enabling timely interventions such as anticoagulation therapy or surgical consultation. Elevated D-dimer levels serve as independent predictors of mortality and are valuable in risk stratification for AOMI patients, improving clinical management and potentially survival outcomes.