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Byline: A. F. Shorr (1), R. F. Trotta (1), S. A. Alkins (1), G. S. Hanzel (1), L. F. Diehl (1) Keywords: Key words D-dimer; Disseminated intravascular coagulation; Mortality Abstract: Objective: To determine if D-dimer predicts outcomes in critically ill patients. Design: Observational, cohort study. Setting: Medical intensive care unit (MICU) of a tertiary care hospital. Patients and participants: Seventy-four patients consecutively admitted to the MICU. Interventions: D-dimer was measured by latex agglutination within 12 h of admission to the MICU. Measurements and results: Of the study population, 43.2 % had positive D-dimers. The in-hospital mortality rate in D-dimer positive patients was 28.1 % as compared to 7.1 % in D-dimer negative subjects (p = 0.024). D-dimer positive patients had significantly greater frequencies of venous thromboses (21.9 % vs 4.8 %, p = 0.035). Conclusions: The D-dimer assay identifies patients at increased risk for mortality and may be a more sensitive test to determine the presence of underlying microvascular pathology in critically ill patients. A positive D-dimer at admission to the MICU is associated with an increased risk for the later development of a venous thromboembolic event (VTE). Author Affiliation: (1) Pulmonary and Critical Care Medicine Service, Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307, U. S. A., email: Andrew _ F. Shorr @ WRAMAA. CHCS.AMEDD.ARMY.MIL Tel. + 1 2 02-7 82-67 45 Fax + 1 2 02-7 82-90 32 Article note: Received: 25 May 1998 Final revision received: 7 October 1998 Accepted: 9 December 1998