• Guifang Yang, Wen Peng, Yang Zhou, Huaping He, Xiaogao Pan, Yuzhong Cai, and Xiangping Chai.
• Department of Emergency Medicine, the Second Xiangya Hospital of Central South University, 139 Renmin road, Changsha, Hunan province 410011, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China. Electronic address: yangguifang@csu.edu.cn.
• Am J Emerg Med. 2020 Sep 1; 38 (9): 182018241820-1824.

BackgroundEvidence regarding the characteristics and prognosis in acute type A aortic dissection (AAD) patients with negative D-dimer result is limited. We aimed to investigate the characteristics and prognosis in AAD patients with negative D-dimer result.Methods And Results370 AAD patients within 24 h of symptom onset were enrolled in a hospital in China from January 2014 to December 2018. Nine (2.43%) and 361 (97.57%) exhibited negative and positive D-dimer results, respectively. The average age of nine negative D-dimer result participants was 47.67 ± 10.95 years old, and about seven (77.78%) of them were male. The negative group showed a significantly lower blood pressure, white blood cell, hemoglobin, activated partial thromboplastin, ejection fraction and symptom with pain than the positive group. Multivariate analysis showed white blood cell (×109/L) (P = 0.008; odds ratio, 0.566) and symptom with pain (P < 0.001; odds ratio, 0.013) were significantly related to a negative result. The result of the fully-adjusted model showed negative D-dimer result was negatively associated with in-hospital mortality compared with positive group in AAD patients after adjusting confounders (OR = 0.34, 95%CI 0.01 to 10.82).ConclusionsNegative D-dimer result is strongly influenced by white blood cell and symptom with pain. Negative D-dimer result was negatively associated with in-hospital mortality compared with positive group in AAD patients.Copyright © 2020 Elsevier Inc. All rights reserved.

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