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Correlation of a high D‐dimer level with poor outcome in traumatic intracranial hemorrhage
Author(s) -
Kuo J.R.,
Lin K.C.,
Lu C.L.,
Lin H.J.,
Wang C.C.,
Chang C. H.
Publication year - 2007
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2007.01908.x
Subject(s) - medicine , glasgow coma scale , d dimer , traumatic brain injury , glasgow outcome scale , midline shift , subarachnoid hemorrhage , receiver operating characteristic , anesthesia , surgery , computed tomography , psychiatry
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 μ g/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 μ g/l, with sensitivity and specificity of 100% and 83%, respectively. D‐dimer ≥1496 μ g/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.