Vol. 15 No. 1 (2023): Arch Pub Health
Clinical Science

Correlation of plasma D-dimers with stages of liver cirrhosis and its complications

Anche Volkanovska
University Clinic for Gastroenterohepatology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
Violeta Dejanova
Institute for Transfusion Medicine; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
Vladimir Andreevski
University Clinic for Gastroenterohepatology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
Meri Trajkovska
University Clinic for Gastroenterohepatology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
Danica Labudovikj
Institute of Medical Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia

Published 2023-06-30


  • Model for End-Stage Liver Disease,
  • Child-Pugh-Turcotte,
  • liver cirrhosis,
  • D-dimer,
  • hyperfibrinolysis

How to Cite

Volkanovska A, Dejanova V, Andreevski V, Trajkovska M, Labudovikj D. Correlation of plasma D-dimers with stages of liver cirrhosis and its complications. Arch Pub Health [Internet]. 2023 Jun. 30 [cited 2023 Dec. 6];15(1):52-6. Available from: https://id-press.eu/aph/article/view/6089


Aim of the study: To investigate plasma D-dimer levels in correlation with Child-Pugh-Turcotte (CTP) and Model for End-Stage Liver Disease (MELD) scores in patients with liver cirrhosis (LC) of different severity, as well as the correlation with LC-associated clinical, biochemical parameters and complications. Material and methods: Fifty patients with LC were divided in three groups according to LC severity using the CTP Score (CTP-A, CTP-B, CTP-C).  The levels of D-dimer were measured in sodium-citrate plasma on Siemens, BCS XP Blood Coagulometer. Kruskal-Wallis test was used to compare D-dimer levels between the groups. Mann-Whitney U test was used to evaluate the difference of D-dimer levels in groups with different MELD score, and to evaluate the difference in D-dimer levels in patients with presence or absence of ascites and the difference of D-dimer levels in patients with or without spontaneous bacterial peritonitis (SBP). Pearson’s coefficient of correlation was used to evaluate the correlation between D-dimer levels with MELD score and the correlation between D-dimer levels and the concentration of LC-associated biochemical, clinical parameters and complications. Results: D-dimer levels increased with severity of the disease as assessed with CTP and MELD scores, with a statistically significant difference between the groups (p=.0000 and p=.0001, respectively). Group CTP-C demonstrated the highest D-dimer levels, followed by groups B and A. Patients with SBP had significantly higher levels of D-dimers than patients without SBP (p=.0006). A significant positive correlation between D-dimers and CTP and MELD score was detected (r= 0.74 and r=0.44, respectively; p<.001). A correlation between D-dimer levels and several biochemical parameters characterizing progressive liver dysfunction was observed. From all investigated biochemical parameters, the highest significant correlation was detected between D-dimer levels and the concentration of serum albumin (r= -0.65, p<.001). Conclusions: Plasma D-dimer levels are tightly correlated with the degree of liver dysfunction and LC-associated complications. Therefore, D-dimer levels could be utilized as a prognostic stratification marker and adjunctive diagnostic marker in LC-associated complications. 


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