J Clin Neurol.  2011 Dec;7(4):197-202. 10.3988/jcn.2011.7.4.197.

Predictors of Poor Outcome in Patients with Acute Cerebral Infarction

Affiliations
  • 1Department of Neurology, Toyama University Hospital, Toyama, Japan. dougu@med.u-toyama.ac.jp
  • 2Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.

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.

Keyword

cerebral infarction; D-dimer; stroke; outcomes; atrial fibrillation; gender

MeSH Terms

Atrial Fibrillation
Cerebral Infarction
Female
Fibrin Fibrinogen Degradation Products
Hospitalization
Humans
Ischemic Attack, Transient
Male
Multivariate Analysis
Odds Ratio
Plasma
Stroke
Fibrin Fibrinogen Degradation Products

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Jung-Min So, Tae-Won Kim, In-Uk Song, Jeong-Wook Park, Sung-Woo Chung, Kwang-Soo Lee
J Neurocrit Care. 2015;8(2):85-90.    doi: 10.18700/jnc.2015.8.2.85.


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