the prognostic value of d-dimer levels for injury outcomes in trauma patients: a systematic review and meta-analysis

Objectives: this study aimed to systematically review and quantify the association between d-dimer levels and injury outcomes in trauma patients through a meta-analysis.methods: 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).results: 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).conclusion: 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.