Assessing the Predictive Value of D-dimer in Acute Pancreatitis: A Systematic Review and Meta-analysis

Introduction: Acute Pancreatitis (AP) often leads to multi-organ dysfunction with high morbidity and mortality necessitating early identification for optimal management. Traditional severity scores have limitations, prompting exploration of biomarkers like D-dimer. Aim: To evaluate D-dimer’s accuracy as a severity marker in AP when compared to theother biomarkers. Materials and Methods: The present comprehensive search was conducted on multiple databases. The authors included randomised clinical trials, cohort, cross-sectional, and casecontrol studies with adults diagnosed with AP and D-dimer measurements. Non-human studies, case reports, and nonEnglish articles were excluded. Risk of bias was assessed using the Newcastle-Ottawa Scale. Data were analysed with R software focusing on diagnostic accuracy. Results: Nineteen studies met the inclusion criteria. Most were retrospective with predominantly male participants. The pooled sensitivity for D-dimer in identifying Severe AP (SAP) was 0.85 (95% CI: 0.78-0.91), and specificity was 0.58 (95% CI: 0.31-0.85). The AUC for diagnostic accuracy was 0.75 (95% CI: 0.66-0.83). For severity assessment, sensitivity was 0.77 (95% CI: 0.71-0.83), specificity was 0.75 (95% CI: 0.67- 0.83), and AUC was 0.78 (95% CI: 0.73-0.83). D-dimer had 0.86 sensitivity for organ failure detection (AUC 0.72, 95% CI: 0.63-0.81). Conclusion: D-dimer shows moderate-to-high accuracy in identifying SAP and predicting organ failure. It is a promising, cost-effective, and easily accessible biomarker for early severity assessment. Further research is needed to confirm its clinical role and integration into severity models.