The Prognostic Value of D-Dimer Levels for Injury Outcomes in Trauma Patients: A Systematic Review and Meta-Analysis

This study aimed to systematically review and quantify the association between D-dimer levels and injury outcomes in trauma patients through a meta-analysis.

A systematic literature search of PubMed, MEDLINE/PubMed, and Web of Science was conducted from 2011 to 2023, supplemented by manual reference list searches. Two independent reviewers assessed the risk of bias using the Newcastle-Ottawa Scale. The primary outcomes were mortality and deep vein thrombosis (DVT).

Of 84 identified articles, 17 were eligible for full-text assessment, and 12 were included in the final analysis. A random-effects model was used to pool the study results. The analysis revealed a statistically significant difference in mean D-dimer levels between patients with poor outcomes and those without poor outcomes (p=0.0003). The standardized mean difference (SMD) was 0.51 (95% confidence interval [CI]:0.24 to 0.79). Furthermore, a significant difference in mean D-dimer levels was observed between survivors and non-survivors (p=0.03, SMD:0.42, 95% CI:0.04-0.79) and between patients with DVT and those without DVT (p=0.0008, SMD:0.79, 95% CI:0.32-1.25).

This meta-analysis indicated that elevated D-dimer levels upon admission could be a valuable prognostic marker in trauma patients and might help predict poor outcomes.