Elevated Hemostasis Markers after Pneumonia Increases One-Year Risk of All-Cause and Cardiovascular Deaths
2011

Elevated Hemostasis Markers after Pneumonia Increases One-Year Risk of Death

Sample size: 893 publication 10 minutes Evidence: high

Author Information

Author(s): Yende Sachin, D'Angelo Gina, Mayr Florian, Kellum John A., Weissfeld Lisa, Kaynar A. Murat, Young Tammy, Irani Kaikobad, Angus Derek C.

Primary Institution: The Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, University of Pittsburgh

Hypothesis

Circulating hemostasis markers activated during community-acquired pneumonia persist at hospital discharge and are associated with higher mortality.

Conclusion

Elevations of TAT and D-dimer levels at hospital discharge are common in patients who appeared to have recovered from pneumonia and are linked to a higher risk of subsequent deaths, especially from cardiovascular disease.

Supporting Evidence

  • Elevated D-dimer and TAT levels were found in 78.8% and 30.1% of subjects at discharge.
  • Higher D-dimer and TAT levels were associated with increased risk of all-cause mortality.
  • 22.3% of deaths within a year were due to cardiovascular causes.
  • Most subjects who died from cardiovascular causes did not report prior cardiovascular disease.
  • Patients with high D-dimer levels had a higher hazard of death, especially in the first few months after discharge.

Takeaway

After getting pneumonia, some people still have high levels of certain markers in their blood that can mean they might die sooner, especially from heart problems.

Methodology

Measured hemostasis markers at hospital discharge in survivors of community-acquired pneumonia and tracked 1-year mortality.

Potential Biases

Potential confounding by unmeasured pre-existing conditions and the inability to measure platelet function.

Limitations

Only fatal cardiovascular events were assessed; pre-infection levels of D-dimer were not available.

Participant Demographics

Mean age 68.7 years, approximately half female, 22.5% had pre-existing cardiovascular disease, mostly non-Hispanic white.

Statistical Information

P-Value

0.0001

Confidence Interval

1.66-1.17 for D-dimer, 1.49-1.1 for TAT

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0022847

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