The Value of Serum D-dimer in Predicting Mortality of Children with Liver Cirrhosis: A Prospective Study

Background: Liver cirrhosis is one of the major causes of mortality worldwide. Finding new methods to stratify patients with liver cirrhosis can affect the treatment plan and improve the outcomes. The present study aimed to determine the prognostic value of the serum D-dimer level in pediatric patients with liver cirrhosis.Method: All cirrhotic pediatric patients admitted to Namazi Hospital (Shiraz, Iran) between November ۲۰۲۰ and November ۲۰۲۱ underwent serum D-dimer level testing on admission and were prospectively analyzed for ۹۰ days. The Mann-Whitney U test was used to evaluate the correlation between D-dimer level and patient mortality. In addition, ROC (Receiver Operating Curve) analysis was used to evaluate the specificity and sensitivity of the D-dimer level in predicting mortality.Result: In total, ۳۸ patients with cirrhosis were included in this study. The serum D-dimer level was significantly correlated with the mortality of children with liver cirrhosis (P = ۰.۰۱), and the area under the ROC of the serum D-dimer level for this prediction was ۰.۷۷۷ (P = ۰.۰۱). The best cut-off D-dimer value was ۱۶۴۱.۵ ng/ml, which offered a sensitivity of ۷۰.۰% and specificity of ۸۲.۱۴% for predicting mortality. We detected no significant correlation between the D-dimer level and the PELD (Pediatric End-stage Liver Disease) or MELD (Model for End-stage Liver Disease) score.Conclusion: The D-dimer level is significantly associated with the mortality of children with cirrhosis. Therefore, D-dimer testing can be used as a stratification marker to prioritize patients waiting on the liver transplant list

کلیدواژه ها:

Liver Cirrhosis ، pediatric patients ، D-dimer ، Prognostic factor