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. 2021 Jun;7(2):134-140.
doi: 10.5114/ceh.2021.105915. Epub 2021 May 14.

Serum and ascitic D-dimer in cirrhotic patients with spontaneous bacterial peritonitis

Ahmed M El Gohary  1 , Amany S Elyamany  1 , Neveen L Mikhael  2 , Mahmoud G Mahmoud  3 , Marwa Mohamed Reda Tawfik  1   4
Affiliations

Serum and ascitic D-dimer in cirrhotic patients with spontaneous bacterial peritonitis

Ahmed M El Gohary et al. Clin Exp Hepatol. 2021 Jun.

Abstract

Aim of the study: The study aimed to investigate serum and ascitic fluid D-dimer level in patients with liver cirrhosis with and without ascites and to evaluate the impact of spontaneous bacterial peritonitis (SBP) on circulating serum and ascitic fluid D-dimer levels.

Material and methods: This study was conducted on 60 subjects who were further subdivided into group I comprising 15 patients with liver cirrhosis and no ascites, group II comprising 15 cirrhotic patients with ascites, group III comprising 15 cirrhotic patients with ascites and SBP, and group IV comprising 15 healthy controls. All patients were subjected to full history taking, physical examination, laboratory investigations, and measurement of serum D-dimer in all groups and ascitic fluid D-dimer in groups II and III. The diagnostic performance of serum D-dimer was tested to detect SBP.

Results: Serum D-dimer differed significantly between groups III and IV, whilst no significant differences were detected between the other groups and group IV. Moreover, group III showed a significantly higher level of serum D-dimer. Ascitic fluid D-dimer mean levels showed no statistically significant differences. A statistically significant positive correlation was found between serum D-dimer level and ascitic fluid D-dimer in group III, r = 0.682. Using a sensitivity and specificity level of 80%, a cut-off value (COV) of > 323.2 ng/ml could differentiate between patients with SBP and patients with ascites only.

Conclusions: Serum D-dimer significantly correlated with ascitic fluid D-dimer in patients with SBP, whereas no significant correlation was found in patients with cirrhotic ascites without bacterial infection. D-dimer showed good diagnostic performance for SBP among patients with liver cirrhosis.

Keywords: D-dimer; ascites; liver cirrhosis; spontaneous bacterial peritonitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
A) Correlation between serum D-dimer level and ascitic fluid D-dimer in group III. B) Correlation between serum D-dimer level and ascitic fluid D-dimer in group II
Fig. 2
Fig. 2
ROC of serum D-dimer to differentiate between SBP and A) group I: liver disease without ascites, B) group II: liver disease with ascites, and C) group IV: no liver disease or ascites
See this image and copyright information in PMC

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