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High Plasma D-Dimer Levels Correlate with Ictal Infarction and Poor Outcomes in Spontaneous Subarachnoid Hemorrhage.
Kobata, Hitoshi; Sugie, Akira; Tucker, Adam; Sarapuddin, Gemmalynn; Kimura, Hitomi; Takeshita, Hitoshi; Morihara, Munenori; Kawakami, Makiko.
Afiliación
  • Kobata H; Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan; Department of Neurosurgery/Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan. Electronic address: hitoshi.kobata@ompu.ac.jp.
  • Sugie A; Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan; Emergency Medical Center, Ijinkai Takeda General Hospital, Kyoto, Japan.
  • Tucker A; Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan; Department of Neurosurgery, Japanese Red Cross Kitami Hospital, Kitakami, Hokkaido, Japan.
  • Sarapuddin G; Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan; Neurology Department, Institute of Neurosciences, The Medical City, Pasig, Metro Manila, Philippines.
  • Kimura H; Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan; Department of Clinical Laboratory, Osaka Medical and Pharmaceutical University Mishima-Minami Hospital, Takatsuki, Japan.
  • Takeshita H; Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan; Department of Clinical Laboratory, Kyoto Tachibana University, Kyoto, Japan.
  • Morihara M; Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan; Department of Radiology, Osaka Mishima Emergency Medical Center, Takatsuki, Japan.
  • Kawakami M; Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan; Department of Anesthesiology, Osaka Saiseikai Suita Hospital, Suita, Japan.
World Neurosurg ; 2024 Aug 14.
Article en En | MEDLINE | ID: mdl-39128614
ABSTRACT

BACKGROUND:

Early brain injury is the leading cause of poor outcomes in spontaneous subarachnoid hemorrhage (sSAH). Plasma D-dimer levels and acute cerebral ischemia have been highlighted as relevant findings in early brain injury; however, their correlation has not been substantially investigated.

METHODS:

This retrospective, single-center cohort study was conducted at a tertiary emergency medical center from January 2004 to June 2022. Consecutive patients with sSAH who presented within 12 hours of ictus and underwent magnetic resonance imaging within 3 days were included. We assessed the correlation of plasma D-dimer levels with acute ischemic lesions detected on the diffusion-weighted imageing and the clinical characteristics.

RESULTS:

Among 402 eligible patients (mean age, 63.5 years; 62.7% women; median time from onset to arrival, 45.5 minutes), 140 (34.8%) had acute ischemic lesions. Higher plasma D-dimer levels linearly correlated with worse neurological grades, more severe SAH on initial computed tomography, acute ischemic lesions, and poor outcomes, except for patients with neurogenic stunned myocardium. In the multivariate analysis, acute ischemic lesions were significantly associated with worse neurological grades, higher plasma D-dimer levels, bilateral loss of light reaction, and advanced age. The receiver operating characteristic curve analysis showed D-dimer levels as excellent predictors for acute ischemic lesions (area under the curve, 0.897; cut-off value, 5.7 µg/mL; P<0.0001) and unfavorable outcomes (area under the curve, 0.786; cut-off value, 4.0 µg/mL; P<0.0001).

CONCLUSIONS:

High plasma D-dimer levels correlated with the appearance of acute ischemic lesions on diffusion-weighted imaging and were dose-dependently associated with worse neurological grades, more severe hemorrhage, and worse outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos