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Correlation of a high D-dimer level with poor outcome in traumatic intracranial hemorrhage
Article first published online: 31 JUL 2007
European Journal of Neurology
Volume 14, Issue 10, pages 1073–1078, October 2007
How to Cite
Kuo, J.-R., Lin, K.-C., Lu, C.-L., Lin, H.-J., Wang, C.-C. and Chang, C. H. (2007), Correlation of a high D-dimer level with poor outcome in traumatic intracranial hemorrhage. European Journal of Neurology, 14: 1073–1078. doi: 10.1111/j.1468-1331.2007.01908.x
- Issue published online: 31 JUL 2007
- Article first published online: 31 JUL 2007
- Received 24 October 2006 Accepted 16 June 2007
- D-dimer level;
- traumatic and non-traumatic ICH
The correlations between D-dimer and Glasgow Coma Scale (GCS), pupillary light reflex, distance of midline shift on brain computed tomography (CT), and Glasgow Outcome Score (GOS) in patients with trauma/non-trauma intracranial hemorrhage (ICH) are not consistent in studies. Ninety-eight traumatic and 59 non-traumatic ICH patients were studied. Pre-existing venous thrombosis, recent surgery, drug use (aspirin or coumadin), or malignancy, were excluded. D-dimer level was estimated within hours after acute insult, and statistical analyses were used for comparisons between groups. Traumatic ICH patients had higher D-dimer levels than controls (2984 vs. 256 μg/l; P = 0.001). The GCS, midline shift on brain CT, pupillary reflex, and GOS at 3 months were significantly correlated with high D-dimer value in traumatic patients (individual P < 0.001), but not in the non-traumatic group. Using receiver-operating characteristic curve (ROC), the cutoff point was 1496 μg/l, with sensitivity and specificity of 100% and 83%, respectively. D-dimer ≥1496 μg/l predicted a poor outcome [adjusted odds ratio (OR) 14.44, 95% CI 1.16–179.27; P = 0.038]. A high D-dimer level is associated with a poor outcome in patients with traumatic ICH. It can be used in addition to neurological assessment to predict the outcome.