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OBJECTIVE:To investigate if systemic d-dimer activation occurs after acute intracerebral hemorrhage(ICH)and to study its influence on clinical outcome.METHODS:The authors determined plasma baseline d-dimer in 98 consecutive acute(< 24 hours)ICH patients.Glasgow Coma Scale and NIH Stroke Scale scores were recorded to assess neurologic status on baseline and follow-up visits(24 hours,48 hours,7th day,and 3rd month).They also determined the d-dimer temporal profile at follow-up visits in a subgroup of 21 patients.ICH volume was measured on baseline and follow-up CT scans.Early neurologic deterioration(END)and mortality during the 1st week were recorded.RESULTS:ICH patients showed higher plasma d-dimer level than reference laboratory values at baseline(1,780 vs 360 ng/mL;p = 0.013)and 3 months after ICH onset(1,530 vs 470 ng/mL;p = 0.013).The d-dimer level was related to baseline ICH volume(r = 0.23,p = 0.049)and to the presence of intraventricular(2,370 vs 1,360 ng/mL;p = 0.019)or subarachnoid(4,180 vs 1,520 ng/mL;p = 0.001)extension.Nearly one-fourth of patients presented END,and 20%died as a result of ICH.As predictors of END,the authors identified d-dimer level >1,900 ng/mL(odds ratio [OR] 4.5,95%CI 1.03 to 20.26,p = 0.045)and systolic blood pressure >182 mm Hg(OR 6.8,95%CI 1.25 to 36.9,p = 0.026).Moreover,ICH volume >30 mL(OR 19.13,95%CI 2.06 to 177,p = 0.009)and d-dimer levels >1,900 ng/mL(OR 8.75,95%CI 1.41 to 54.16,p = 0.020)emerged as independent predictors of mortality.CONCLUSION:Increased plasma d-dimer level following acute intracerebral hemorrhage is associated with early neurologic deterioration and poor outcome.
OBJECTIVE: To investigate if systemic d-dimer activation occurs after acute intracerebral hemorrhage (ICH) and to study its influence on clinical outcome. METHODS: The authors determined plasma baseline d-dimer in 98 consecutive acute (<24 hours) ICH patients. Glasgow Coma Scale and NIH Stroke Scale scores were recorded to assess neurologic status on baseline and follow-up visits (24 hours, 48 hours, 7th day, and 3rd month). They also determined the d-dimer temporal profile at follow-up visits in IC subgroups of 21 patients. IC volume was measured on baseline and follow-up CT scans. Early neurologic deterioration (END) and mortality during the first week were recorded .RESULTS: ICH patients showed higher plasma d-dimer level than reference laboratory values at The d-dimer level was related to baseline ICH volume (r = 0.23, p = 0.013) and 3 months after ICH onset (1,530 vs 470 ng / mL; p = 0.049) and to the presence of intraventricular (2,370 vs 1,360 ng / mL; p = 0.019) or subarac As predicted by ICH. As predictors of END, the authors identified d-dimer level> 1,900 ng / mL (4,180 vs 1,520 ng / mL; p = 0.001) mL (odds ratio [OR] 4.5, 95% CI 1.03 to 20.26, p = 0.045) and systolic blood pressure> 182 mm Hg (OR 6.8, 95% CI 1.25 to 36.9, p = 0.026) (OR 19.13, 95% CI 2.06 to 177, p = 0.009) and d-dimer levels> 1,900 ng / mL (OR 8.75,95% CI 1.41 to 54.16, p = 0.020) emerged as independent predictors of mortality. CONCLUSION: Increased plasma d-dimer level following acute intracerebral hemorrhage is associated with early neurologic deterioration and poor outcome.