title: Serum D-dimer as a predictor of mortality in patients with acute spontaneous intracerebral hemorrhage.
abstract: It has been found that the hemostatic system is activated following a brain injury. To explore the role of D-dimer in spontaneous intracerebral hemorrhage (ICH), this prospective study aimed to evaluate the association between serum D-dimer concentration, clinical outcome and radiographic findings of ICH patients in the emergency department (ED). Patients with acute (<24 hours) spontaneous ICH were enrolled in this study. The D-dimer concentration was related to: baseline ICH volume (r=0.198, p=0.01); Glasgow Coma Scale (GCS) score 3-8 (p=0.01); GCS score 13-15 (p=0.002); midline shift >15 mm (p=0.016); and to subarachnoid extension of the blood (p<0.0001). Diabetes mellitus (odds ratio [OR]: 2.93; 95% confidence interval [CI]: 1.1-7.76, p=0.031), ICH volume (OR: 1.16; 95% CI: 1.07-1.27, p<0.0001) and D-dimer concentration (OR: 2.72; 95% CI: 1.08-6.9, p=0.002) were associated with 30-day mortality. This study shows that in patients with spontaneous ICH, a higher initial D-dimer concentration is associated with higher 30-day mortality.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6 W. Sec., Jiapu Road, Puzih City, Chiayi County 613, Taiwan.
authors.forename: Chun-Cheng
authors.initials: CC
authors.lastname: Chiu
authors.forename: Yi-Nong
authors.initials: YN
authors.lastname: Li
authors.forename: Leng-Jye
authors.initials: LJ
authors.lastname: Lin
authors.forename: Cheng-Ting
authors.initials: CT
authors.lastname: Hsiao
authors.forename: Kuang-Yu
authors.initials: KY
authors.lastname: Hsiao
authors.forename: I-Chuan
authors.initials: IC
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D