Qi Zhou1, Daming Zhang2,3, Xin Chen2,3, Zhao Yang4, Zhihui Liu5, Baixing Wei6, Mei Jin2, Kairu Feng2, Chunmei Guo2, Junying Sun2, Sheng Chen6, Ruijia Zhang6, Xiai Piao6, Ilgiz Gareev7, Zhenying Sun2,3, Xiaoxiong Wang2,3, Lili Li2, Shiguang Zhao2,3, Guang Yang2,3. 1. Research Administration Office, The First Affiliated Hospital of Harbin Medical University, Harbin, China. 2. Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China. 3. Institute of Brain Science, Harbin Medical University, Harbin, China. 4. Department of Neurosurgery, The Fourth Hospital of Harbin Medical University, Harbin, China. 5. Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. 6. Harbin Medical University, Harbin, China. 7. Bashkir State Medical University, Ufa, Russia.
Abstract
BACKGROUND: The elevation of plasma D-dimer levels may predict a higher risk of thrombosis and play a role in the pathological process of patients after spontaneous intracerebral hemorrhage (ICH). However, its function in predicting the prognosis of ICH has not been verified on large cases. PATIENTS AND METHODS: Retrospective cohort study of 1,332 consecutive patients with spontaneous ICH at an academic medical center was conducted. Functional outcome at three months after ICH was dichotomized using the modified Rankin Scale (0-2 versus 3-6). D-dimer level in blood was analyzed within 1 hr of admission. An ICH outcome score combining D-dimer level for evaluating poor functional outcome and mortality was tested. RESULTS: The proportion of patients with poor functional outcome and mortality at three months was significantly higher in patients with elevated D-dimer level (p < .001). Multivariable analysis demonstrated that elevated D-dimer level was an independent predictor of poor functional outcome (odds ratio 1.486, 95% confidence interval 1.086-2.060, p = .014) and mortality (odds ratio 2.015, 95% confidence interval 1.186-3.423, p = .01). An increasing ICH outcome score combining D-dimer level was associated with increased poor functional outcome and mortality. CONCLUSIONS: Elevated plasma D-dimer level after spontaneous ICH is associated with poor functional outcome and mortality. The study suggests that elevated D-dimer level has a predictive value for outcome and mortality in patients with spontaneous ICH.
BACKGROUND: The elevation of plasma D-dimer levels may predict a higher risk of thrombosis and play a role in the pathological process of patients after spontaneous intracerebral hemorrhage (ICH). However, its function in predicting the prognosis of ICH has not been verified on large cases. PATIENTS AND METHODS: Retrospective cohort study of 1,332 consecutive patients with spontaneous ICH at an academic medical center was conducted. Functional outcome at three months after ICH was dichotomized using the modified Rankin Scale (0-2 versus 3-6). D-dimer level in blood was analyzed within 1 hr of admission. An ICH outcome score combining D-dimer level for evaluating poor functional outcome and mortality was tested. RESULTS: The proportion of patients with poor functional outcome and mortality at three months was significantly higher in patients with elevated D-dimer level (p < .001). Multivariable analysis demonstrated that elevated D-dimer level was an independent predictor of poor functional outcome (odds ratio 1.486, 95% confidence interval 1.086-2.060, p = .014) and mortality (odds ratio 2.015, 95% confidence interval 1.186-3.423, p = .01). An increasing ICH outcome score combining D-dimer level was associated with increased poor functional outcome and mortality. CONCLUSIONS: Elevated plasma D-dimer level after spontaneous ICH is associated with poor functional outcome and mortality. The study suggests that elevated D-dimer level has a predictive value for outcome and mortality in patients with spontaneous ICH.
Authors: Rui Guo; David J Blacker; Xia Wang; Hisatomi Arima; Pablo M Lavados; Richard I Lindley; John Chalmers; Craig S Anderson; Thompson Robinson Journal: Neurosurgery Date: 2017-12-01 Impact factor: 4.654
Authors: Michael L James; Carl D Langefeld; Padmini Sekar; Charles J Moomaw; Mitchell S V Elkind; Bradford B Worrall; Kevin N Sheth; Sharyl R Martini; Jennifer Osborne; Daniel Woo Journal: Neurology Date: 2017-07-14 Impact factor: 9.910
Authors: Duncan Wilson; David J Seiffge; Christopher Traenka; Ghazala Basir; Jan C Purrucker; Timolaos Rizos; Oluwaseun A Sobowale; Hanne Sallinen; Shin-Joe Yeh; Teddy Y Wu; Marc Ferrigno; Rik Houben; Floris H B M Schreuder; Luke A Perry; Jun Tanaka; Marion Boulanger; Rustam Al-Shahi Salman; Hans R Jäger; Gareth Ambler; Clare Shakeshaft; Yusuke Yakushiji; Philip M C Choi; Julie Staals; Charlotte Cordonnier; Jiann-Shing Jeng; Roland Veltkamp; Dar Dowlatshahi; Stefan T Engelter; Adrian R Parry-Jones; Atte Meretoja; David J Werring Journal: Neurology Date: 2017-04-05 Impact factor: 9.910