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High Plasma Levels of d-Dimer Are Independently Associated with a Heightened Risk of Deep Vein Thrombosis in Patients with Intracerebral Hemorrhage

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Abstract

Deep venous thrombosis (DVT) is a complication of stroke. Our aim was to determine whether d-dimer plasma levels at admission could be a risk factor for DVT in Chinese patients with acute intracerebral hemorrhage (ICH). From December 2012 to November 2014, all patients with first-ever acute ICH were included. At baseline, the demographical and clinical data were taken. These patients were assessed for DVT using color Doppler ultrasonography (CDUS) on 15 days after ICH and whenever clinically requested. Multivariate analyses were performed using logistic regression models. Receiver operating characteristic (ROC) curves were used to test the overall predictive accuracy of d-dimer and other markers. In our study, acute ICH was diagnosed in 265 patients and 210 completed a 15-day follow-up and were included in the analysis. Fifty-four (25.7 %) out of the 210 patients were diagnosed as DVT. Plasma d-dimer levels were significantly higher in ICH patients with DVT as compared to those without DVT (P < 0.0001). Multivariate logistic regression analysis adjusted for common risk factors showed that plasma d-dimer levels ≥1.20 mg/L were an independent predictor of DVT [odds ratio (OR) = 12.99, 95 % confidence interval (CI) = 3.17–32.98; P < 0.0001]. With an area under the curve (AUC) of 0.91 (95 % CI = 0.86–0.94), d-dimer showed a significantly greater discriminatory ability to predict DVT as compared with high-sensitivity C-reactive protein (Hs-CRP) (AUC = 0.77, 95 % CI = 0.70–0.82; P < 0.01), homocysteine (HCY) (AUC = 0.75, 95 % CI = 0.70–0.81; P < 0.01), and National Institutes of Health Stroke Scale (NIHSS) score (AUC = 0.80, 95 % CI = 0.72–0.85; P < 0.01). The present study suggested that elevated d-dimer plasma levels were independent predictors for DVT in Chinese patients with ICH.

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Acknowledgments

We are grateful to the Department of Neurology and Emergency; the nurses, physicians, and patients who participated in our study; and the staff of the central laboratory of the hospital.

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Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi Area, Zhengzhou, 450000, Henan Province, People’s Republic of China

    Xuan Cheng, Lu Zhang, Nan-Chang Xie, Yun-Qing Ma & Ya-Jun Lian

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  1. Xuan Cheng
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  2. Lu Zhang
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Correspondence to Ya-Jun Lian.

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Cheng, X., Zhang, L., Xie, NC. et al. High Plasma Levels of d-Dimer Are Independently Associated with a Heightened Risk of Deep Vein Thrombosis in Patients with Intracerebral Hemorrhage. Mol Neurobiol 53, 5671–5678 (2016). https://doi.org/10.1007/s12035-015-9487-5

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  • DOI: https://doi.org/10.1007/s12035-015-9487-5

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