Usefulness of the d-dimer to albumin ratio for risk assessment in patients with acute variceal bleeding at the emergency department: retrospective observational study
Dublin Core
Title
Usefulness of the d-dimer to albumin ratio for risk assessment in patients with acute variceal bleeding at the emergency department: retrospective observational study
Subject
Esophageal and Gastric Varices, Risk assessment, D-dimer, albumin
Description
Background: Acute variceal bleeding (AVB) is a severe complication of portal hypertension that is caused by rupture
of the esophageal or gastric varix. Scoring system for risk stratifcation of AVB is difcult to use because various variables must be entered, and it is difcult to apply early in the emergency department (ED). We compared and analyzed
the usefulness of the D-dimer to albumin ratio (DAR) for risk stratifcation of AVB.
Methods: In this retrospective observational study, medical records of patients with AVB Between January 2019
and December 2020 were assessed. The primary endpoint was to evaluate whether DAR was a predictor of clinical
outcomes for AVB. Receiver operating characteristic (ROC) curves were constructed using cut-of values determined
by the Youden Index. Univariate and multivariate logistic regression analyses were performed to assess the factors
contributing to the development of outcomes.
Results: Overall, 67 patients required intensive care. The cut-of value of DAR for patients requiring intensive care was
400. A DAR>400 (adjusted HR: 5.636 [95% CI: 2.216–14.332]) independently predicted the need for ICU admission in
these patients. Overall, 13 patients required long-term hospitalization. The cut-of value of DAR for patients requiring
long-term hospitalization was 403. A DAR>403 (adjusted HR: 9.899 [95% CI: 2.012–48.694]) independently predicted
the need for long-term hospitalization. Overall, 95 patients required transfusion. The cut-of value of DAR for patients
requiring transfusion was 121. A DAR>121 (adjusted HR: 4.680 [95% CI: 1.703–12.862]) independently predicted the
need for transfusion. Overall, 11 patients died during study period. The cut-of value of DAR for mortality was 450. A
DAR>450 (adjusted HR: 26.261 [95% CI: 3.054–225.827]) independently predicted mortality.
Conclusions: The DAR can be used for outcome assessment in patients with AVB with various scoring systems, but
its explanatory power is not high.
of the esophageal or gastric varix. Scoring system for risk stratifcation of AVB is difcult to use because various variables must be entered, and it is difcult to apply early in the emergency department (ED). We compared and analyzed
the usefulness of the D-dimer to albumin ratio (DAR) for risk stratifcation of AVB.
Methods: In this retrospective observational study, medical records of patients with AVB Between January 2019
and December 2020 were assessed. The primary endpoint was to evaluate whether DAR was a predictor of clinical
outcomes for AVB. Receiver operating characteristic (ROC) curves were constructed using cut-of values determined
by the Youden Index. Univariate and multivariate logistic regression analyses were performed to assess the factors
contributing to the development of outcomes.
Results: Overall, 67 patients required intensive care. The cut-of value of DAR for patients requiring intensive care was
400. A DAR>400 (adjusted HR: 5.636 [95% CI: 2.216–14.332]) independently predicted the need for ICU admission in
these patients. Overall, 13 patients required long-term hospitalization. The cut-of value of DAR for patients requiring
long-term hospitalization was 403. A DAR>403 (adjusted HR: 9.899 [95% CI: 2.012–48.694]) independently predicted
the need for long-term hospitalization. Overall, 95 patients required transfusion. The cut-of value of DAR for patients
requiring transfusion was 121. A DAR>121 (adjusted HR: 4.680 [95% CI: 1.703–12.862]) independently predicted the
need for transfusion. Overall, 11 patients died during study period. The cut-of value of DAR for mortality was 450. A
DAR>450 (adjusted HR: 26.261 [95% CI: 3.054–225.827]) independently predicted mortality.
Conclusions: The DAR can be used for outcome assessment in patients with AVB with various scoring systems, but
its explanatory power is not high.
Creator
Jun Seok Seo , Yongwon Kim , Yoonsuk Lee , Ho Young Chung and Tae Youn Kim
Publisher
BMC Emergency Medicine
Date
(2022) 22:135
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Jun Seok Seo , Yongwon Kim , Yoonsuk Lee , Ho Young Chung and Tae Youn Kim, “Usefulness of the d-dimer to albumin ratio for risk assessment in patients with acute variceal bleeding at the emergency department: retrospective observational study,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/4242.