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Abstract
Introduction
Ischemic stroke has emerged as a major source of morbidity and mortality all over the world and especially in India where the number of patients of diabetes, hypertension and coronary heart disease is on the rise. Plus the financial burden incurred during the care of stroke patients can be overwhelming not only for the families but also for the healthcare system in general. Hence newer tools for decreasing risk of developing ischemic stroke and for its early detection and prognostication need to be constantly looked into. In our study one particular prognostic tool and intervention for early detection and prognostication of ischemic stroke, namely plasma d-dimer was studied. We studied the d-dimer values in ischemic strokes and the association of d-dimer values with the clinical severity of ischemic stroke at the time of admission as defined by the NIHSS score.
Aim
To study d-dimer levels in acute ischemic stroke and the correlation of plasma d-dimer levels with the severity of stroke.
Methods
The study was a cross sectional study carried out over 18 months at Safdarjung hospital, New Delhi. As part of the study, it was predecided to select 150 ischemic stroke patients and find out their plasma d-dimer levels. The clinical severity of stroke was also calculated using the NIHSS scores which is an objective scale to assess stroke severity.
Results
In our study it was found that patients who were hospitalized with acute ischemic stroke had significantly higher d-dimer values (mean 468.09, median 368, S.D 281.71,p<0.0001) than those in the control group(mean 138.94, median 127, S.D 56.92).We also found that patients with higher d-dimer levels had more severe stroke as defined by NIHSS score.(p<0.0001).
Conclusions
D-dimer values are elevated in ischemic stroke and higher d-dimer values correlated with clinically more severe strokes. Hence d-dimer shows promise as a marker for diagnosis and assessment of severity of ischemic strokes.