Age-dependent patterns of D-dimer and APTT for VTE in severe pneumonia: a multicenter retrospective study.
7 affiliations
- 1State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
- 2Meizhou People's Hospital, No. 63 Huangtang Road, Jiangnan New District, Meizhou, Guangdong, 514031, P. R. China.
- 3Guangzhou Huadu District People's Hospital, Huadu District, Guangzhou, Guangdong Province, 510800, China.
- 4Department of Medical Imaging, The Second School of Clinical Medicine, Guangzhou Medical University, Guangzhou, 511436, China.
- 5State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. [email protected].
- 6State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. [email protected].
- 7State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. [email protected].
Abstract
Objective
To investigate age-stratified patterns of admission D-dimer and activated partial thromboplastin time (APTT) and their complementary value for venous thromboembolism (VTE) detection in severe community-acquired pneumonia (SCAP).Methods
This multicenter retrospective study consecutively enrolled 577 patients with SCAP admitted to two tertiary hospitals from January 2019 to December 2023. Admission coagulation parameters were compared using the Mann-Whitney U test. D-dimer values were natural log-transformed and analyzed using generalized linear models (GLMs) with a Gamma distribution and log link function. Additionally, activated partial thromboplastin time (APTT), fibrinogen, prothrombin time, and international normalized ratio (INR) were fitted using Gaussian GLMs with an identity link, each adjusted for nine prespecified covariates. The independent contribution of Ln (D-dimer) to VTE was assessed through multivariable logistic regression, with discrimination evaluated by the area under the receiver operating characteristic curve (AUC).Results
VTE occurred in 86 of 577 patients (14.9%). The VTE group demonstrated significantly higher D-dimer levels (Z = -5.785, P < 0.001). Adjusted generalized linear models (GLMs) confirmed markedly elevated Ln(D-dimer) (Wald χ² = 32.186, P < 0.001) and reduced APTT (Wald χ² = 3.935, P = 0.047) in the VTE cohort. The interaction between age and VTE did not reach statistical significance (Ln(D-dimer): P = 0.666; APTT: P = 0.075). In age-stratified analyses, significant differences in Ln (D-dimer) persisted across both age groups (both P < 0.001), whereas APTT shortening was limited to patients aged < 65 years (-5.80 s, 95% CI, -10.55 to -1.05; P = 0.017) and was not observed in those aged ≥ 65 years (-0.34 s, 95% CI, -4.06 to 3.39; P = 0.859). Ln (D-dimer) was an independent predictor of VTE (adjusted OR 2.462, 95% CI, 1.789 to 3.388, P < 0.001), with an area under the curve (AUC) of 0.747 (95% CI, 0.689 to 0.805).Conclusion
In SCAP inpatients, VTE was linked to elevated D-dimer levels and a shortened APTT. The association with D-dimer was consistent across all age groups, whereas the shortening of APTT was primarily observed in younger patients. These age-stratified findings are exploratory due to the non-significant interaction (P = 0.075) and require prospective validation.
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BibTeX
@article{wen2026agedependent,
title = {{Age-dependent patterns of D-dimer and APTT for VTE in severe pneumonia: a multicenter retrospective study.}},
author = {Qiuhong Wen and Shumin Chen and Lingling Hong and Jiayi Lin and Jiashun Li and Weizhi Liang and Qian Jiang and Ni Ren and Nuofu Zhang and Ning Lai and Chunli Liu},
journal = {Thrombosis journal},
year = {2026},
month = oct,
doi = {10.1186/s12959-026-00930-0},
url = {https://europepmc.org/article/MED/42919385},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Age-dependent patterns of D-dimer and APTT for VTE in severe pneumonia: a multicenter retrospective study.
AU - Qiuhong Wen
AU - Shumin Chen
AU - Lingling Hong
AU - Jiayi Lin
AU - Jiashun Li
AU - Weizhi Liang
AU - Qian Jiang
AU - Ni Ren
AU - Nuofu Zhang
AU - Ning Lai
AU - Chunli Liu
PY - 2026
DA - 2026/10/06
JO - Thrombosis journal
DO - 10.1186/s12959-026-00930-0
UR - https://europepmc.org/article/MED/42919385
AB - Objective To investigate age-stratified patterns of admission D-dimer and activated partial thromboplastin time (APTT) and their complementary value for venous thromboembolism (VTE) detection in severe community-acquired pneumonia (SCAP).Methods This multicenter retrospective study consecutively enrolled 577 patients with SCAP admitted to two tertiary hospitals from January 2019 to December 2023. Admission coagulation parameters were compared using the Mann-Whitney U test. D-dimer values were natural log-transformed and analyzed using generalized linear models (GLMs) with a Gamma distribution and log link function. Additionally, activated partial thromboplastin time (APTT), fibrinogen, prothrombin time, and international normalized ratio (INR) were fitted using Gaussian GLMs with an identity link, each adjusted for nine prespecified covariates. The independent contribution of Ln (D-dimer) to VTE was assessed through multivariable logistic regression, with discrimination evaluated by the area under the receiver operating characteristic curve (AUC).Results VTE occurred in 86 of 577 patients (14.9%). The VTE group demonstrated significantly higher D-dimer levels (Z = -5.785, P < 0.001). Adjusted generalized linear models (GLMs) confirmed markedly elevated Ln(D-dimer) (Wald χ² = 32.186, P < 0.001) and reduced APTT (Wald χ² = 3.935, P = 0.047) in the VTE cohort. The interaction between age and VTE did not reach statistical significance (Ln(D-dimer): P = 0.666; APTT: P = 0.075). In age-stratified analyses, significant differences in Ln (D-dimer) persisted across both age groups (both P < 0.001), whereas APTT shortening was limited to patients aged < 65 years (-5.80 s, 95% CI, -10.55 to -1.05; P = 0.017) and was not observed in those aged ≥ 65 years (-0.34 s, 95% CI, -4.06 to 3.39; P = 0.859). Ln (D-dimer) was an independent predictor of VTE (adjusted OR 2.462, 95% CI, 1.789 to 3.388, P < 0.001), with an area under the curve (AUC) of 0.747 (95% CI, 0.689 to 0.805).Conclusion In SCAP inpatients, VTE was linked to elevated D-dimer levels and a shortened APTT. The association with D-dimer was consistent across all age groups, whereas the shortening of APTT was primarily observed in younger patients. These age-stratified findings are exploratory due to the non-significant interaction (P = 0.075) and require prospective validation.
SN - 1477-9560
ER -