Role of Serum D-Dimer in Early Prediction of Organ Failure in Acute Pancreatitis: A Retrospective Study

Abstract

Background: Acute pancreatitis (AP) is a common gastrointestinal emergency with clinical outcomes ranging from mild self-limiting disease to severe systemic inflammation and multiorgan dysfunction. Early identification of patients at risk of organ failure remains essential for timely intervention. Serum D-dimer, a degradation product of cross-linked fibrin, has emerged as a potential biomarker reflecting activation of coagulation and inflammatory pathways.
Objective: To evaluate the role of serum D-dimer in early prediction of organ failure among patients with acute pancreatitis.
Methods: A retrospective observational study was conducted among 69 patients diagnosed with acute pancreatitis admitted between July 2020 and November 2021 at a tertiary care center in Hyderabad. Demographic details, laboratory parameters, D-dimer levels, clinical severity, and occurrence of organ failure were analyzed. Statistical analysis included independent t-test, chi-square test, logistic regression, and ROC analysis.
Results: Among 69 patients, organ failure developed in 21 (30.4%) patients. Mean serum D-dimer levels were significantly higher among patients developing organ failure compared to those without organ failure (3.72 ± 1.41 vs 1.58 ± 0.82 μg/mL; p<0.001). ROC analysis demonstrated an AUC of 0.86 with an optimal cut-off value of 2.45 μg/mL showing sensitivity of 81.0% and specificity of 79.2%.
Conclusion: Elevated serum D-dimer may serve as an early predictor of organ failure in acute pancreatitis and may assist clinicians in risk stratification during early hospitalization.