D-dimer-to-platelet Ratio as a Novel Marker of in-hospital Adverse Outcomes Among Patients With Acute Pulmonary Embolism: a Single-center Retrospective Study

Abstract Background: This retrospective study aimed to evaluate the value of D-dimer to platelets ratio (DPR) in predicting the in-hospital prognosis of patients with acute pulmonary embolism (APE).Methods: We retrospectively reviewed the medical records of 237 patients with APE admitted from January 2016 to August 2020. The associations between the DPR and other predictors and serious adverse events were analyzed with univariate and multivariate analyses.Results: A total of 134 (56.5%) patients were categorized into the low DPR group (DPR <4.55) and 103 (43.5%) in the high DPR group (DPR ≥4.55) according to the cut-off value for the DPR of 4.55 with a sensitivity of 87.5% and a specificity of 62.0%, respectively. The model that included DPR revealed a significant improvement in the accuracy of the predictive value compared with the sPESI score alone (AUC: 0.721 [95% CI: 0.636-0.807]; P <0.001 vs AUC: 0.607 [95% CI: 0.496-0.718]; P=0.085; respectively. Multivariate analysis showed that DPR (P=0.001) and the pulmonary embolus position (P=0.011) were independent factors of serious adverse events (SAEs) of APE inpatients. The in-hospital SAEs rate was significantly higher in the high DPR group compared with the low DPR group.Conclusion: Our findings showed that DPR is seemed to be a novel marker of risk stratification in patients with APE. This parameter may be used to identify these patients at higher risk for clinical adverse events, and individualization of therapeutic interventions should be timely considered.