D-dimer cutoff values for predicting functional prognosis in patients with severe head trauma: a multi-centre...

Area of Science:

• Neuroscience
• Trauma Care
• Biomarker Research

Background:

• Traumatic brain injury (TBI) is a significant cause of mortality and disability.
• D-dimer, a marker of fibrinolysis, has shown potential in predicting outcomes in various critical conditions.
• Early identification of patients with severe TBI at risk for poor functional outcomes is crucial for timely intervention.

Purpose of the Study:

• To determine optimal D-dimer cutoff values for predicting poor functional outcomes in severe TBI patients.
• To investigate the association between early D-dimer levels and neurological function post-TBI.

Main Methods:

• A multi-center prospective observational cohort study included 336 severe TBI patients (GCS ≤ 8) admitted within 1 hour of injury.
• Neurological function was assessed using the modified Rankin Scale (mRS) at discharge.
• Logistic regression and receiver operating characteristic (ROC) curve analysis were used to determine D-dimer's predictive utility and optimal cutoff values.

Main Results:

• Over 63% of patients (214/336) experienced poor neurological function (mRS ≥ 4).
• D-dimer levels greater than 27.2 µg/mL at admission were significantly associated with poor functional prognosis (OR = 3.84).
• The area under the ROC curve (AUC) for D-dimer was 0.73, indicating moderate predictive accuracy.

Conclusions:

• An early D-dimer cutoff value of 27.2 µg/mL can predict functional prognosis in patients with severe isolated TBI.
• D-dimer serves as a valuable, accessible biomarker for risk stratification in severe TBI management.