The Important Role of Preoperative D-Dimer in Constrictive Pericarditis

Figures & data

Table 1 Postoperative Complications After Pericardiectomy

Variables	N	Percentage
Total	59	37.3%
Cardiac complications	34	21.5%
Low cardiac output	27	17.0%
Atrial fibrillation	6	3.8%
Ventricular fibrillation	2	1.3%
Pulmonary complications	20	12.7%
Pneumonia	16	10.1%
Acute respiratory failure	4	2.5%
Atelectasis	3	1.9%
Pulmonary embolism	1	0.6%
Acute liver or kidney injury	14	8.9%
Acute liver injury	9	5.7%
Acute kidney injury	8	5.1%
Deep vein thrombosis	4	2.5%

Figure 1 Analysis of the diagnostic value of coagulation indicators for postoperative complications. (A) ROC curve analysis of the diagnostic value of DD; (B) ROC curve analysis of the diagnostic value of APTT; (C) ROC curve analysis of the diagnostic value of PT; (D) ROC curve analysis of the diagnostic value of INR; (E) ROC curve analysis of the diagnostic value of TT; (F) ROC curve analysis of the diagnostic value of FBG.

Abbreviations: DD, d-dimer; APTT, activated partial thromboplastin time; PT, prothrombin time; INR, international normalized ratio; TT, thrombin time; FBG, fibrinogen.

Figure 2 Analysis of the diagnostic value of D-dimer for different postoperative complications. (A) ROC curve analysis of the diagnostic value for cardiac complications; (B) ROC curve analysis of the diagnostic value for pulmonary complications; (C) ROC curve analysis of the diagnostic value for acute liver or kidney injury; (D) ROC curve analysis of the diagnostic value for deep vein thrombosis.

Table 2 Preoperative Baseline Characteristics of the Patients

Variables	Low DD Group (N=74)	High DD Group (N=84)	P value
Gender			0.958
Male	57 (77.0%)	65 (77.4%)
Female	17 (23.0%)	19 (22.6%)
Age, years	58 (18–79)	61 (16–83)	0.791
Etiology			0.031
Tuberculosis	63 (85.1%)	80 (95.2%)
Idiopathic	11 (14.9%)	4 (4.8%)
Smoking			0.093
Never	36 (48.6%)	55 (65.5%)
Former	23 (31.1%)	16 (19.0%)
Current	15 (20.3%)	13 (15.5%)
Alcohol drinking			0.323
Never	50 (67.6%)	65 (77.4%)
Former	8 (10.8%)	8 (9.5%)
Current	16 (21.6%)	11 (13.1%)
BMI, kg/m^2	21.5 (16.3–33.1)	21.4 (14.9–31.6)	0.206
NYHA functional class			0.692
I	3 (4.1%)	4 (4.8%)
II	37 (50.0%)	34 (40.5%)
III	32 (43.2%)	43 (51.2%)
IV	2 (2.7%)	3 (3.6%)
Hypertension	16 (21.6%)	15 (17.9%)	0.552
Diabetes	11 (14.9%)	3 (3.6%)	0.013
Atrial fibrillation	7 (9.5%)	15 (18.1%)	0.121
COPD	0 (0%)	3 (3.6%)	0.290
HIV	0 (0%)	0 (0%)	/
CHD	4 (5.4%)	5 (6.0%)	1.000
PVD	2 (2.7%)	5 (6.0%)	0.546
Stroke	0 (0%)	2 (2.4%)	0.499
DVT	2 (2.7%)	8 (9.5%)	0.153
Pericardial calcification	10 (13.5%)	20 (23.8%)	0.100
Pericardial thickness, mm	8.6 (3.4–18.4)	10.1 (4.0–22.0)	<0.001
CVP, cmH2O	25.3 (13.0–40.0)	27.0 (14.0–50.0)	0.066
LVEF, %	58.4 (46.0–75.2)	59.1 (42.0–78.0)	0.976
Platelets, 10^9/L	134.5 (71–321)	160 (77–383)	0.015
APTT, sec	30.0 (20.3–40.3)	28.9 (21.7–46.9)	0.292
PT, sec	12.6 (9.5–15.7)	13.5 (10.8–16.6)	<0.001
INR	1.07 (0.87–1.31)	1.13 (0.93–1.40)	<0.001
TT, sec	16.7 (13.2–23.0)	16.8 (13.3–21.5)	0.280
FBG, mg/dL	342 (145–527)	357 (169–570)	0.497
CRP, mg/L	12.1 (0.8–71.5)	21.9 (1.0–86.4)	<0.001
ESR, mm/h	21.5 (2.0–90.0)	36.0 (2.0–129.0)	0.001
BNP, pg/mL	175 (15–786)	199 (21–961)	0.089

Notes: Values presented as N (percentage) for categorical variables and median (range) for continuous variables.

Abbreviations: DD, d-dimer; NYHA, New York Heart Association; COPD, chronic obstructive pulmonary disease; HIV, human immunodeficiency virus; CHD, coronary heart disease; PVD, peripheral vascular disease; DVT, deep vein thrombosis; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; CVP, central venous pressure; LVEF, left ventricular ejection fraction (measured on echocardiogram); APTT, activated partial thromboplastin time; PT, prothrombin time; INR, international normalized ratio; TT, thrombin time; FBG, fibrinogen; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; BNP, brain natriuretic peptide.

Table 3 Comparison of Postoperative Outcomes

Variables	Low DD Group (N=74)	High DD Group (N=84)	P value
CVP, cmH2O	13.0 (3.0–28.0)	14.0 (2.0–32.0)	0.063
BNP, pg/mL	190 (27–803)	247 (25–1553)	0.024
ICU stay*, days	2 (0–10)	2 (0–11)	0.008
Intubation, h	19.5 (0–212)	21 (0–232)	0.020
Duration of vasoactive agents, h	0 (0–231)	13 (0–161)	0.018
Complications	12 (16.2%)	47 (56.0%)	<0.001
Duration of chest drainage, days	10 (4–27)	13 (4–52)	0.004
Hospital stay, days	15 (8–31)	18 (7–60)	0.002
In-hospital mortality	0 (0.0%)	1 (1.2%)	1.000

Notes: Values presented as median (range) for continuous variables and N (percentage) for categorical variables. *The average ± standard deviation of ICU stay (days) was 2.3±1.8 and 3.1±2.2 in low DD group and high DD group, respectively.

Abbreviations: DD, d-dimer; CVP, central venous pressure; BNP, brain natriuretic peptide; ICU, intensive care unit.

Table 4 Effect of Preoperative DD Level on Postoperative Complications

Groups	Univariable Analysis			Multivariable Analysis
	OR	95% CI	P value	OR	95% CI	P value
Low DD group	1	/	/	1	/	/
High DD group	6.563	3.090–13.942	< 0.001	6.892	2.604–18.235	< 0.001

Abbreviations: DD, d-dimer; OR, odds ratio; CI, confidence interval.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.