Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Association between D-Dimer Levels and the Prognosis of Terminal Cancer Patients in the Last Hours of Life

  • Lee, Hwan Hee (Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine) ;
  • Hwang, In Cheol (Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine) ;
  • Shin, Jinyoung (Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine)
  • Received : 2019.10.01
  • Accepted : 2020.02.04
  • Published : 2020.03.01
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Abstract

Purpose: D-dimer levels are known to be associated with poor outcomes in patients with various cancers, but their significance at the end of life remains unclear. This study investigated D-dimer levels as a prognostic indicator for terminal cancer patients in the last hours of life. Methods: The retrospective study was conducted at a palliative care unit of a tertiary cancer center, using a database to analyze the records of patients treated from January 1, 2010 to December 31, 2018. In total, 67 terminal cancer patients with available data on D-dimer levels were included. Patients' demographic data, clinical information, and laboratory values, including D-dimer levels, were collected. Survival was analyzed using the Kaplan-Meier method and the log-rank test. A Cox proportional-hazards model was used to identify prognostic factors of poor survival. Results: The most common site of cancer was the lung (32.8%) and the median survival time was 5 days. Most laboratory results, particularly D-dimer levels, deviated from the normal range. Patients with high D-dimer levels had a significantly shorter survival time than those with low D-dimer levels (4 days vs. 7 days; P=0.012). In the Cox regression analysis, only a high D-dimer level was identified as a predictor of a poor prognosis (hazard ratio, 1.83; 95% confidence interval, 1.09~3.07). Conclusion: Our results suggest that at the very end of life, D-dimer levels may serve as a prognostic factor for survival in cancer patients.

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References

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