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Predictors of poor outcome in patients with acute cerebral infarction
Nobuhiro Dougu1, Shutaro Takashima, Etsuko Sasahara
1Department of Neurology, Toyama University Hospital, Toyama, Japan. dougu@med.u-toyama.ac.jp
Insights
Elevated D-dimer levels and specific clinical factors like female gender and advanced age can predict poor outcomes in acute cerebral infarction (CI) patients within 30 days. This aids in early risk assessment for stroke patients.
Area of Science:
- Neurology
- Biomarkers
- Clinical Medicine
Background:
- Plasma D-dimer levels increase during acute cerebral infarction (CI).
- Predicting poor outcomes in CI patients is crucial for timely intervention.
Purpose of the Study:
- To determine if admission D-dimer levels and clinical characteristics predict poor outcomes in acute CI patients.
- To identify independent predictors of poor outcomes in acute CI.
Main Methods:
- Compared clinical characteristics and plasma D-dimer levels within 3 days of onset in acute CI patients.
- Analyzed outcomes at 30 days post-hospitalization using modified Rankin scale (mRS).
Main Results:
- 359 patients analyzed; 174 had poor outcomes (mRS ≥3).
- Poor outcomes were more frequent in women, those with cardioembolism, atrial fibrillation, advanced age (≥75 years), prior CI/TIA, and elevated D-dimer (≥1.0 µg/mL).
- Independent predictors of poor outcome included elevated D-dimer (OR 2.45), advanced age (OR 1.93), and female gender (OR 1.75).
Conclusions:
- Admission D-dimer levels, advanced age, and female gender are independent predictors of poor 30-day outcomes in acute CI.
- These factors can aid in predicting the prognosis of patients with acute cerebral infarction.
Background And Purpose:
Plasma D-dimer levels are elevated during the acute phase of cerebral infarction (CI). We investigated whether the D-dimer level on admission and other clinical characteristics could be used to predict the poor outcome of patients with acute CI.
Methods:
The clinical characteristics and plasma D-dimer levels measured within 3 days of onset were compared according to outcome among patients with acute CI.
Results:
In total, 359 consecutive patients (mean age, 71.8 years) were examined, of which 174 had a poor outcome [score on the modified Rankin scale (mRS) ≥3] at 30 days after hospitalization. The mean mRS score was higher and a poor outcome was observed more frequently among women than among men (p<0.001 for each). The proportions of women, cardioembolism, atrial fibrillation, advanced age (≥75 years), prior history of CI or transient ischemic attack, and elevated D-dimer level (≥1.0 µg/mL) were significantly higher among patients with a poor outcome than among those with a good outcome. A multivariate analysis showed that elevated D-dimer level [≥1.0 µg/mL; odds ratio (OR), 2.45; 95% confidence interval (95% CI), 1.52-3.89; p<0.01], advanced age (OR, 1.93; 95% CI, 1.21-3.07; p<0.01), and female gender (OR, 1.75; 95% CI, 1.08-2.83; p=0.02) were independent predictors of a poor outcome.
Conclusions:
Certain clinical characteristics (gender and advanced age) and an elevated D-dimer level upon admission can be used to predict the outcome of patients with acute CI at 30 days after hospitalization.
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