The Clinical Value of D-dimer level in Patients with Non-aneurysmal Subarachnoid Hemorrhage.

The Clinical Value of D-dimer level in Patients with Non-aneurysmal Subarachnoid Hemorrhage.

World Neurosurg. 2018 Mar 31;:

Authors: Zheng J, Cheng C, Zhou C, Chen H, Guo Z, Sun X

Abstract
OBJECTIVE: A growing number of non-aneurysmal subarachnoid hemorrhage (NaSAH) were found in clinical practice. However, the precise mechanisms in which D-dimer level is associated with clinical condition in patients with NaSAH remain unclear. But even more, the data assessing the risk of clinical course in the patients with NaSAH are scarce. Our objective was to investigate whether D-dimer levels correlated with complication and outcome in patients with NaSAH.
METHODS: Between February 2013 and May 2017, 92 patients suffering from NaSAH were treated in our hospital. Patient characteristics, radiological features, laboratory findings, complications and outcomes were analyzed retrospectively. Patients were stratified perimesencephalic (PM) SAH group and non-perimesencephalic (NPM) SAH group according to the bleeding type, and NPM-SAH group further was divided into two subgroups including NPM-elevated group and NPM-normal group based on the value of D-dimer. After Statistical analysis, compared NPM-SAH and PM-SAH groups, then NPM-elevated group was also compared with NPM-normal group.
RESULTS: The rate of complications in NPM-SAH group was higher than in PM-SAH group, including early hydrocephalus, delayed cerebral ischemia, clinical vasospasm, pneumonia, hyponatremia. Our results showed that D-dimer levels in patients with NPM-SAH were clearly higher than in those with PM-SAH. Further analysis of subgroups demonstrated Patients with elevated D-dimer levels had a higher incidence of complications than those with normal D-dimer levels, especially the risks of shunt dependent hydrocephalus and pneumonia. Moreover, the disability and even death could be seen in patients with higher levels of D-dimer, but the differences of long-term outcomes were not particularly obvious between these groups.
CONCLUSIONS: Elevated D-dimer levels on admission were significantly associated with complication of patients with NPM-SAH, In addition to conventional radiological diagnosis, D-dimer level augments the ability of rapid differential diagnosis between NPM-SAH and PM-SAH.

PMID: 29614358 [PubMed - as supplied by publisher]

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