High Levels of D-Dimer are Associated with Poor Hospitalization Outcome of Spontaneous Intraparenchymal Haemorrhage

Xuguang Chen,* Shengyi Shi,* Lan Hu Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medical, Shanghai, 201800, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lan Hu, Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medical, Shanghai, 201800, People’s Republic of China, Tel +86 181-2126-3197, Email 442037735@qq.comObjective: To investigate whether D-dimer levels and changes in D-dimer levels can be used as effective indexes to evaluate the risk of death among intraparenchymal haemorrhage (IPH) patients.Methods: A retrospective cohort study of 732 patients with IPH was conducted at an academic medical centre. The risk factors for adverse hospitalization outcomes were analysed, and logistic multivariate analysis was performed. Patients were divided into supratentorial, brainstem and cerebellum groups. According to whether intraventricular haematoma (IVH) and subarachnoid haematoma (SAH) co-occurred, the supratentorial group was divided into simple haematoma, combined IVH, combined SAH and combined IVH+SAH subgroups. The relationship between D-dimer levels and hospitalization outcome in each group/ subgroup was analysed.Results: Compared with survivors, the plasma D-dimer level of the nonsurvivors on the second day after admission was significantly higher (2.52 ± 3.89 μg/mL vs 0.77 ± 2.31 μg/mL, P = 0.032), and the difference in plasma D-dimer levels between the second day after admission and admission significantly increased (1.77 ± 3.70 μg/mL vs 0.26 ± 2.80 μg/mL, P = 0.049), and a D-dimer level on day 2 > 0.58 μg/mL was an independent risk factor for mortality among IPH patients (OR 3.114, 95% CI: 1.007). In the supratentorial group and the IVH subgroup, the level of D-dimer on day 2 was significantly higher among nonsurvivors than among survivors (2.18 ± 2.13 μg/mL vs 0.65 ± 1.04 μg/mL, P = 0.011; 2.45 ± 2.31 μg/mL vs 0.91 ± 1.26 μg/mL, P = 0.028, respectively).Conclusion: The increase in plasma D-dimer levels on day 2 is related to poor hospitalization outcomes of patients with IPH, and this correlation may exist only among patients with both IVH and IPH.Keywords: intraparenchymal hemorrhage, D-dimer, hospitalization outcomes