Elevated plasma D-dimer level is associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study
Elevated level of plasma D-dimer increases the risk of ischemic stroke, stroke severity and progression of stroke status, but the association between plasma D-dimer level and functional outcome is unclear. The aim of this study is to investigate whether Plasma D-dimer level is a determinant of short-term poor functional outcome in patients with acute ischemic stroke (AIS). Methods: This prospective study included 877 Chinese patients with AIS admitted to Renmin Hospital of Wuhan University
... han University within 72 hours of symptom onset. Patients were categorized per plasma D-dimer level: Quartile 1( 0.24 mg /L), Quartile 2 (0.25-0.56 mg /L), Quartile 3 (0.57-1.78 mg /L), and Quartile 4 ( 1.78mg /L). Each patient's medical record was reviewed, and demographic, clinical, laboratory and neuroimaging information was abstracted. Functional outcome at 90 days was assessed with the modified Rankin Scale (mRS). Results: Of 877 patients were included (mean age, 64 years; male, 68.5%), poor outcome was present in 302 (34.4%) patients. After adjustment for potential confounding variables, higher plasma D-dimer level on admission was associated with poor outcome (adjusted odds ratio aOR 2.257, 95% CI1.349-3.777 for Q4:Q1; P trend = 0.004). According to receiver operating characteristic (ROC) analysis, the best discriminating factor was a plasma D-dimer level 0.315 mg/L for pour outcome area under the ROC curve (AUC) 0.657; sensitivity 83.8%; specificity 41.4%. Conclusion: Elevated plasma D-dimer level on admission was significantly associated with increased poor outcome after admission for AIS, suggesting the potential role of plasma D-dimer as a predictive marker for short-term poor outcome in patients with AIS.