Turkish Journal of Geriatrics 2022 , Vol 25, Issue 2
THE PROGNOSTIC AND DIAGNOSTIC VALUE OF PLASMA D-DIMER LEVELS IN ELDERLY PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA
Sertan BULUT2, Deniz ÇELİK1, Harun KARAMANLI2
1Alanya Alaaddin Keykubat University, Faculty of Medicine, Department of Pulmonology, ANTALYA, Turkey
2University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital,, Department of Pulmonology, ANKARA, Turkey
DOI : 10.31086/tjgeri.2022.284 Introduction: This study aimed to investigate the relationship between community-acquired pneumonia severity and D-dimer levels in individuals older than 65. We also investigated the relationship between D-dimer levels and the adverse outcomes in patients with community-acquired pneumonia after excluding all other potential causes of high D-dimer levels.

Materials and Methods: Patients older than 65 who were admitted to the emergency service of a tertiary chest diseases training and research hospital between January 1, 2019, and October 1, 2020, were evaluated. Patients who met the diagnostic criteria for community-acquired pneumonia were included. In clinically questionable cases of coexistence of pulmonary embolism and community-acquired pneumonia, D-dimer levels and pulmonary computerize tomography angiography or ventilation-perfusion scintigraphy were examined. Confirmed pulmonary embolism patients were excluded. Of 4,608 patients evaluated, 82 had a diagnosis of community-acquired pneumonia with no comorbidity. The severity of these cases was determined with the CURB-65 score and pneumonia severity index score.

Results: The mean age of the cases was 73.83±6.67 years, while their gender was predominantly male (n=51, 62.2%). A statistically significant correlation was found between D-dimer levels and both the CURB-65 and pneumonia severity index high-risk groups (p=0.001 and p=0.001, respectively). The adverse outcomes were statistically higher in both the CURB-65 and pneumonia severity index high-risk groups (p<0.001).

Conclusions: D-Dimer is an easy-to-interpret, fast, inexpensive, highly sensitive, and simple test widely used in clinics. We found that high levels of D-dimer can predict the need for intensive care unit care, disease severity, and mortality of elderly community-acquired pneumonia patients. Keywords : Pneumonia; Aged; Severity of Illness Index