High initial D/Dimer values coud predict outcome in stroke patients

Introduction/Objectives: Stroke is one of the most common cause of death worldwide and a signifi cant cause of disability among adults. D-dimers (Dd) are marker of thrombin generation and also of cross linked fi brin turnover. Th is study investigated the utility of plasma D-dimer. Participants, Materials/Methods: Plasma samples were drawn from 74 consecutive patients who were addmited to the emergency neurology department under the stroke diagnosis during one year and assayed for fi brinogen and D-dimer. D-dimers were measured by the D-Dimer PLUS (Dade Behring, USA). Results: High Dd and fi brinogen were obtained in 45 (61%) and 47 (64%), respectively. Obtained initial plasma levels of D-dimer, fi brinogen and D/F ratio were 248ng/mL, 4.1g/L and 61, respectively, for all patients. The proportion of patients that did not survive was 16%. Logistic regression model was set up and Dd OR 1.00 95% CI (1.0003-1.003) p=0.015, and hyperlipidemia p=0.01 OR 0.07 95% CI (0.01-0.56)were major independent predictors of fatal outcome. Of all attributes, only D-dimer (and consequently d/F ratio) level had signifi cant ability to discriminate between survivors and non-survivors (P<.0001). The optimal cut point for predicting outcome was 376 mg/L, resulting in specifi city 83%, sensitivity 81%, 35% positive predictive value, and 96% negative predictive value. Conclusions: Initial measurement of D-dimer level, can predict outcome in stroke patients. The optimal cut point for predicting outcome was 376 mg/L. The higer values were obtained in non-survivors who died of VTE complications. When D-dimer above 376 mg/L occurs, further diagnostic testing is necessary to exclude the presence of DVT in stroke patients.