title: Predictors of poor outcome in patients with acute cerebral infarction.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurology, Toyama University Hospital, Toyama, Japan. dougu@med.u-toyama.ac.jp
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Dougu
authors.forename: Shutaro
authors.initials: S
authors.lastname: Takashima
authors.forename: Etsuko
authors.initials: E
authors.lastname: Sasahara
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Taguchi
authors.forename: Shigeo
authors.initials: S
authors.lastname: Toyoda
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Hirai
authors.forename: Takashi
authors.initials: T
authors.lastname: Nozawa
authors.forename: Kortaro
authors.initials: K
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue