Predictors of Poor Outcome in Patients with Acute Cerebral Infarction.
- Author:
Nobuhiro DOUGU
1
;
Shutaro TAKASHIMA
;
Etsuko SASAHARA
;
Yoshiharu TAGUCHI
;
Shigeo TOYODA
;
Tadakazu HIRAI
;
Takashi NOZAWA
;
Kortaro TANAKA
;
Hiroshi INOUE
Author Information
- Publication Type:Original Article
- Keywords: cerebral infarction; D-dimer; stroke; outcomes; atrial fibrillation; gender
- MeSH: Atrial Fibrillation; Cerebral Infarction; Female; Fibrin Fibrinogen Degradation Products; Hospitalization; Humans; Ischemic Attack, Transient; Male; Multivariate Analysis; Odds Ratio; Plasma; Stroke
- From:Journal of Clinical Neurology 2011;7(4):197-202
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND PURPOSE: 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) > or =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 (> or =75 years), prior history of CI or transient ischemic attack, and elevated D-dimer level (> or =1.0 microg/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 [> or =1.0 microg/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.
