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        Predictors of Poor Outcome in Patients with Acute Cerebral Infarction

        Nobuhiro Dougu,Shutaro Takashima,Etsuko Sasahara,Yoshiharu Taguchi,Shigeo Toyoda,Tadakazu Hirai,Takashi Nozawa,Kortaro Tanaka,Hiroshi Inoue 대한신경과학회 2011 Journal of Clinical Neurology Vol.7 No.4

        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) ≥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 (≥75 years), prior history of CI or transient ischemic attack, and elevated D-dimer level (≥1.0 μg/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 [≥1.0 μg/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 Ddimer level upon admission can be used to predict the outcome of patients with acute CI at 30 days after hospitalization.

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