Correlation between D-dimer levels and unfavorable outcomes in patients with spontaneous supratentorial intracerebral hemorrhage after surgery

Abstract

Abstract D-dimer is associated with poor prognosis in hemorrhagic stroke. We determined correlations between poor prognosis and D-dimer in spontaneous supratentorial intracerebral hemorrhage (SSTICH). A total of 557 patients with SSTICH were enrolled and categorized into two subgroups according to the modified Rankin Scale (mRS) score: favorable (0–2) and unfavorable (3–5) outcomes. D-dimer levels were measured within 24 hours and quantified at admission, at post-surgery, and during hospitalization until discharge (mean and peak). A binary logistic regression model was constructed based on between-group differences. The risk of poor prognosis after surgery was 21.874-fold higher with admission D-dimer levels ≥ 2.80 mg/L than < 0.65 mg/L (odds ratio [OR], 21.874; 95% confidence interval [CI], 10.353–46.214; P < 0.001). Postoperative mean D-dimer levels ≥ 6.31 mg/L incurred a 7.109-fold higher risk of poor prognosis (OR, 7.109; 95% CI, 3.623–13.95; P < 0.001). Patients with overall mean D-dimer levels ≥ 5.85 mg/L had a 8.164-fold higher risk of poor prognosis (OR, 8.164; 95% CI, 4.152–16.054; P < 0.001). The highest D-dimer level ≥ 10 mg/L posed a 5.798-fold higher risk of poor prognosis (OR, 5.798; 95% CI, 3.64–13.14; P < 0.001). Elevated D-dimer levels independently predict postoperative unfavorable prognosis in patients with SSTICH, and the risk increases with higher D-dimer levels.