Predictive value of D-dimer and fibrinogen degradation product for splanchnic vein thrombosis in patients with severe acute pancreatitis: a single-center retrospective study

Figures & data

Figure 1. Flow chart of patients with or without SVT secondary to SAP. SAP: severe acute pancreatitis; SVT: splanchnic vein thrombosis.

Table 1. Demographic characteristics and serum laboratory indicators of patients.

		Total (n = 177)	SVT (n = 32)	Non-SVT (n = 145)	χ^2/Z	p
Age		49.86 ± 15.76	49.28 ± 14.623	49.99 ± 16.045	−0.254	0.800
Gender, male		99 (55.9%)	22 (68.8%)	77 (53.1%)	2.604	0.107
Smoking		67 (37.8%)	14 (43.8%)	53 (36.6%)	0.577	0.447
Alcohol drinking		71 (40.1%)	15 (46.9%)	56 (38.6%)	0.744	0.389
Etiology	Biliary	88 (49.8%)	15 (46.8%)	73 (50.3%)
	Alcohol	1 (0.005%)	0 (0%)	1 (0.7%)	4.940	0.293
	Hyperlipidemia	38 (21.5%)	6 (18.8%)	32 (22.1%)
	Mixed factors	26 (14.7%)	3 (9.4%)	23 (15.9%)
	Idiopathic	24 (13.6%)	8 (25%)	16 (11.0%)
Recurrent		43 (24.3%)	12 (37.5%)	31 (21.3%)	3.704	0.054
Modified Marshall		3 (2–4)	3 (3–4.75)	2 (2–4)	−1.526	0.127
BISAP		3 (2–3)	2.5 (2–3)	3 (2–3)	−0.903	0.367
Modified Balthazar CT		8 (6–8)	8 (6–8)	8 (6–8)	−0.047	0.962
WBC		14.9 (10.6–18.2)	15.7 (11.5–19.2)	14.7 (10.5–17.8)	−1.147	0.251
NEU		13.2 (9.3–16.4)	13.8 (9.7–17.1)	13.0 (9.2–16.2)	−1.029	0.303
LYM		1.0 (0.6–1.2)	0.9 (0.6–1.1)	1.0 (0.6–1.2)	−0.591	0.555
NEU-R		87.6 (85.5–91.5)	88.1 (85.8–90.4)	87.5 (85.2–91.6)	−0.341	0.733
LYM-R		7.5 (4.2–8.6)	7.2 (4.4–8.2)	7.5 (4.1–8.8)	−0.025	0.980
HCT		0.4 ± 0.08	0.4 ± 0.1	0.4 ± 0.08	−0.118	0.730
PLT		215 (155–268)	239 (167–323)	210 (154–254)	−1.508	0.132
RDW-CV (%)		14.0 (13.0–14.2)	14.0 (13.1–14.2)	14.0 (12.9–14.2)	−0.641	0.522
PCT		3.2 (0.21–3.2)	3.3 (0.22–3.3)	3.2 (0.17–3.3)	−0.480	0.631
ALB		37.2 ± 6.2	38.4 ± 6.1	36.9 ± 6.3	−0.190	0.236
Ca^2+		2.1 (2.0–2.3)	2.1 (2.0–2.2)	2.1 (2.0–2.3)	−0.137	0.891
AMY		648.7 (130.1–837.9)	453.0 (133.6–483.6)	691.9 (109.1–965.1)	−1.090	0.276
LPS		1009.1 (139.4–1227.6)	621.4 (125.7–920.2)	1094.7 (146.9–1316.5)	−1.147	0.251

WBC: white blood cell; NEU: neutrophil; LYM: lymphocyte; NEU-R: neutrophil ratio; LYM-R: lymphocyte ratio; HCT: hematocrit; PLT: platelet; RDW-CV (%): red cell distribution width variance coefficient; PCT: procalcitonin; ALB: albumin; Ca²⁺: serum calcium; AMY: serum amylase; LPS: serum lipase.

Table 2. Pattern of splanchnic vein thrombosis and anticoagulant therapy.

	Total (n = 32)	Anticoagulated
PV	11 (34.4%)	10
SV	6 (18.8%)	4
SMV	2 (6.3%)	2
PV + SMV	2 (6.3%)	2
PV + SV	7 (21.9%)	5
PV + SV + SMV	4 (12.5%)	4

PV: portal vein; SV: splenic vein; SMV: superior mesenteric vein.

Figure 2. The area under the receiver operating characteristic (ROC) curve for predictive utility of D-Di and FDP for the presence of SVT in SAP are 0.8909 and 0.8578, respectively.

Table 3. The univariate analysis of coagulation and fibrinolysis markers.

	SVT group	Non-SVT group	Z	p
PT	14.4 (13.70–15.30)	14.6 (13.6–15.8)	−0.981	0.327
PT-INR	1.13 (1.06–1.21)	1.14 (1.06–1.25)	−0.754	0.451
PT%	82.00 (74.00–90.65)	81.00 (70.00–91.60)	−0.697	0.486
PT-RATIO	1.13 (1.05–1.17)	1.12 (1.05–1.19)	−0.516	0.606
APTT	38.10 (4.15–43.35)	38.20 (33–43.3)	−0.312	0.755
TT	15.80 (15.10–16.90)	15.9 (14.9–16.9)	−0.138	0.890
FIB	5.79 (4.26–16.90)	5.56 (4.09–7.12)	−0.772	0.440
D-Di	9.35 (7.87–11.71)	4.82 (2.84–6.17)	−11.054	<0.001
FDP	31.78 (27.44–44.11)	16.68 (9.90–24.50)	−10.117	<0.001
AT3	81.00 (72.00–90.50)	81.00 (69.00–92.00)	−0.175	0.861

PT: prothrombin time (PT); PT-INR: international normalized ratio; PT%: prothrombin time activity; PT-RATIO: prothrombin time ratio; APTT: activated partial thromboplastin time; TT: thromboplastin time; FIB: fibrinogen; D-Di: D-dimer; FDP: fibrin degradation products; AT3: antithrombin III.

Table 4. The binary logistic regression of coagulation and fibrinolysis markers.

	B	Wald	OR (95%CI)	p
D-Di	0.127	8.535	1.135 (1.043–1.236)	0.003
FDP	0.037	10.881	1.037 (1.015–1.060)	0.001

D-Di:d-dimer; FDP: fibrin degradation products.

Table 5. The predictive value of D-Di and FDP for SVT in SAP patients.

	AUC	95%CI	Cut-off	Sensitivity	Specificity	Youden Index
D-Di	0.891	0.859–0.923	6.475	95.30%	74.10%	0.741
FDP	0.858	0.822–0.894	23.155	89.40%	72.40%	0.618

D-Di:d-dimer; FDP: fibrin degradation products.

Table 6. Clinical Features and Outcome Between SVT and Non-SVT Group.

	Total (n = 177)	SVT group (n = 32)	Non-SVT group (n = 145)	χ^2/Z	P
Pancreatic necrosis	136 (76.8%)	24 (75%)	112 (77.2%)	0.074	0.786
Pancreatic pseudocyst	20 (11.3%)	7 (21.9%)	13 (8.9%)	4.359	0.037
Pancreatic abscess	7 (4.0%)	3 (9.4%)	4 (2.8%)	3.021	0.082
ascites	139 (78.5%)	24 (75%)	115 (79.3%)	0.289	0.591
Abdominal infection	57 (32.2%)	8 (25%)	49 (33.8%)	0.928	0.335
gastrointestinal hemorrhage	11 (6.2%)	5 (15.6%)	6 (4.1%)	5.935	0.015
PPH	32 (18.1%)	14 (43.8%)	18 (12.41%)	17.381	<0.001
ACS	12 (6.8%)	1 (3.1%)	10 (6.9%)	0.640	0.424
ARDS	47 (26.6%)	8 (25%)	39 (26.9%)	0.048	0.826
AKI	22 (12.4%)	2 (6.25%)	20 (13.8%)	1.370	0.242
SIRS	16 (9.0%)	4 (12.5%)	12 (8.3%)	0.569	0.451
MODS	22 (12.4%)	5 (15.6%)	17 (11.7%)	0.366	0.545
Hospital- stay	18 (12–21)	18 (13–23)	19 (12–21)	−0.247	0.805

PPH: pancreatic portal hypertension; ACS: abdominal compartment syndrome; ARDS: acute respiratory distress syndrome; AKI: acute kidney injury; SIRS: systemic inflammatory response syndrome; MODS: multiple organ dysfunction syndrome.

Data availability statement

The datasets analyzed during our study are available from the corresponding author upon reasonable request.