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This single-center prospective observational study includes 264 ABP patients assessed by Revised Atlanta Classification (2012) and categorized as mild, moderate, or severe. D-dimer levels were measured at admission (H0), 24 h (H24), and 48 h (H48) and compared against Ranson and BISAP scoring. D-dimer rose significantly with severity, with H48 showing the highest discrimination for moderate-to-severe ABP (AUC 0.812).",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/serial-d-dimer-measurements-dynamically-predict-severity-in-acute-biliary-pancreatitis-article-15/455327/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/serial-d-dimer-measurements-dynamically-predict-severity-in-acute-biliary-pancreatitis-article-15/455327.png","ImageObject",300,407,{"name":92,"@type":93},"mieayamfan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical problem does the study address in acute biliary pancreatitis?","Question",{"text":112,"@type":113},"Early risk stratification is needed in ABP, because traditional scoring systems can be complex and may delay treatment decisions. The study examines whether serial D-dimer measurements can improve early assessment.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were patients grouped and how were D-dimer levels measured?",{"text":117,"@type":113},"Patients were categorized as mild, moderate, or severe using the Revised Atlanta Classification (2012). Serum D-dimer was measured at admission (H0), 24 hours (H24), and 48 hours (H48).",{"name":119,"@type":110,"acceptedAnswer":120},"Which D-dimer timepoint performed best compared with Ranson and BISAP?",{"text":121,"@type":113},"The D-dimer level at 48 hours (H48) had the highest discriminative value for predicting moderate-to-severe ABP (AUC 0.812). H24 and H0 also performed well, while Ranson and BISAP showed lower predictive accuracy.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},455327,1791450911,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090893677,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Turkish Journal of Medical Sciences  \n\n| Volume 55  Number 6 | Article 15 |\n| --- | --- |\n| 12-12-2025\u003Cbr>Serial D-dimer measurements dynamically predict severity in acute biliary pancreatitis: a prospective observational study\u003Cbr>KEMAL TEKEŞİNTOLGA CANBAKAYLİN ACAR FATİH BAŞAK HASAN KUMRU\u003Cbr>See next page for additional authors\u003Cbr>Follow this and additional works at: [https://journals.tubitak.gov.tr/medical](https://journals.tubitak.gov.tr/medical)\u003Cbr> Part of the Medical Sciences Commons |  |\n\nRecommended Citation  \nTEKEŞİN, K, CANBAK, T, ACAR, A, BAŞAK, F, KUMRU, H, & ERDEM, O (2025) . Serial D-dimer measurements dynamically predict severity in acute biliary pancreatitis: a prospective observational study. Turkish Journal of Medical Sciences 55 (6): 1480-1486 . [https://doi.org/10.55730/1300-0144.6106](https://doi.org/10.55730/1300-0144.6106)  \nThis work is licensed under a Creative Commons Attribution 4.0 International License.  \nThis Research Article is brought to you for free and open access by TÜBİTAK Academic Journals. It has been accepted for inclusion in Turkish Journal of Medical Sciences by an authorized editor of TÜBİTAK Academic Journals. For more information, please contact [academic.publications@tubitak.gov.tr](academic.publications@tubitak.gov.tr)  \nSerial D-dimer measurements dynamically predict severity in acute biliary pancreatitis: a prospective observational study  \nAuthors  \nKEMAL TEKEŞİN, TOLGA CANBAK, AYLİN ACAR, FATİH BAŞAK, HASAN KUMRU, and OLGUN ERDEM  \nThis research article is available in Turkish Journal of Medical Sciences: [https://journals.tubitak.gov.tr/medical/](https://journals.tubitak.gov.tr/medical/)[ ](https://journals.tubitak.gov.tr/medical/)vol55/iss6/15  \n\n| \u003Cbr>| Turkish Journal of Medical Sciences [http://journals.tubitak.gov.tr/medical/](http://journals.tubitak.gov.tr/medical/)\u003Cbr>\u003Cbr>Research Article | Turk J Med Sci\u003Cbr>(2025) 55: 1480-1486 © TÜBİTAK\u003Cbr>doi:10.55730/1300-0144.6106 |\n| --- | --- | --- |\n\nSerial D-dimer measurements dynamically predict disease severity in acute biliary pancreatitis: a prospective observational study  \nKemal TEKEŞİN*􀁋, Tolga CANBAK􀁋, Aylin ACAR􀁋, Fatih BAŞAK􀁋, Hasan KUMRU􀁋, Olgun ERDEM􀁋 Department of General Surgery, University of Health Sciences, Ümraniye Training and Research Hospital, İstanbul, Turkiye  \nReceived: 31.07.2025  Accepted/Published Online: 30.10.2025  Final Version: 12.12.2025  \nBackground/aim: Early risk stratification is required in cases of acute biliary pancreatitis (ABP) . Traditional scoring systems such as Ranson’s criteria are complex and often delay treatment. D-dimer, a basic marker of systemic inflammation and coagulation, has shown promise as a prognostic tool. The present study investigates whether the predictive accuracy of serial serum D-dimer measurements is superior to that ofthe Ranson and BISAP scoring systems for moderate-to-severe ABP.  \nMaterials and methods: Included in this single-center prospective observational study were 264 patients diagnosed with ABP between July 2022 and July 2025 whose collected data were analyzed. The participants were categorized as mild, moderate, or severe based on the current Revised Atlanta Classification (2012), and D-dimer levels were measured at admission (H0), 24 h (H24), and 48 h (H48), along with their BISAP scores to allow a comparative analysis.  \nResults: Mean D-dimer levels increased significantly with disease severity at all timepoints (p \u003C 0.001) . ROC analysis identified the D-dimer level at H48 to have the highest discriminative value for predicting moderate-to-severe ABP (AUC: 0.812; 95% CI: 0.758– 0.866). The H24 and H0 D-dimer levels also performed well (AUCs: 0.728 and 0.719, respectively) . In comparison, the Ranson (H48 AUC: 0.741) and BISAP scores (H24 AUC: 0.755) yielded lower predictive accuracy – the H48 D-dimer AUC being statistically superior to both (p \u003C 0.05) .  \nConclusion: Serum D-dimer levels are significantly associated with ABP severity and show prom","cbCair0TAaEtgiKm","https://ap.wps.com/l/cbCair0TAaEtgiKm","pdf",546743,"English","# Introduction\n## Background and need for early risk stratification\n# Materials and methods\n## Study design and patient categorization\n## D-dimer measurements and scoring comparisons\n# Results\n## Association between D-dimer levels and severity\n## ROC performance versus Ranson and BISAP\n# Conclusion\n## Clinical implications and need for validation","[{\"question\":\"What clinical problem does the study address in acute biliary pancreatitis?\",\"answer\":\"Early risk stratification is needed in ABP, because traditional scoring systems can be complex and may delay treatment decisions. The study examines whether serial D-dimer measurements can improve early assessment.\"},{\"question\":\"How were patients grouped and how were D-dimer levels measured?\",\"answer\":\"Patients were categorized as mild, moderate, or severe using the Revised Atlanta Classification (2012). Serum D-dimer was measured at admission (H0), 24 hours (H24), and 48 hours (H48).\"},{\"question\":\"Which D-dimer timepoint performed best compared with Ranson and BISAP?\",\"answer\":\"The D-dimer level at 48 hours (H48) had the highest discriminative value for predicting moderate-to-severe ABP (AUC 0.812). H24 and H0 also performed well, while Ranson and BISAP showed lower predictive accuracy.\"}]","Serial D-dimer measurements dynamically predict severity in acute biliary pancreatitis - Article 15 | PDF",1790742621,23]