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Volume 12 Issue 2 ( April- June) 2023

Original Articles

Assessment of D-dimer levels in stroke patients
Dr. Rupesh Singh Yadav, Dr. Amit Sagar, Dr. Kishan Gopal Barupal, Dr. Alok Gupta

Background: Due to increased morbidity and mortality by the complications associated with stroke also lead to high socioeconomic burden. The present study was conducted to study D-dimer levels in stroke patients. Materials & Methods: This study was carried out in the department of Medicine, in indoor patients of associated group of Hospitals attached to Dr. S N medical college, Jodhpur. All gave their written consent to participate in the study.Venous sampling for quantitative measurement of D-dimer was taken at the time of admission. Stroke severity was assessed on admission using the National Institutes of Health Stroke Scale (NIHSS, the NIHSS score with higher values reflect more severe neurological damage). Results: Out of 68 diabetic patients, 92.64% (63) were with raised D-dimer and 7.35% (5) were with normal D-dimer. The association of Diabetes mellitus with raised D-dimer levels was found significant in this study (p- 0.023). Out of 87 patients with raised D-dimer, 51.72% (45) were hypertensive and 48.27% (42) were non-hypertensive. And out of 13 patients with normal D-dimer, 15.38 % (2) were hypertensive and 84.61% (11) were non-hypertensive. The association of hypertension with raised D- dimer levels was found significant in this study (p-0.017). Out of the 87 patients who presented with raised levels of D-dimer 42.53% (37) reported with severe stroke with NIHSS score 21-42 followed by 29.88% (26) with moderate to severe stroke with NIHSS score 16-20, and 25.28% (22) had score in the range of 5-15 that is moderate score. In this study NIHSS score was higher with raised level of D-dimer. There was a significant correlation of NIHSS score with D-dimer level. The association of infarct size with D-dimer. In this study CT scan infarct size increases as level of D-dimer increase. There was a significant correlation of CT scan infarct size with level of D-Dimer. Conclusion: D-dimer values are increased in many conditions of thromboembolism including strokes and also in recent covid. This study highlights the increase in D-dimer levels in ischemic stroke. The rise was statistically significant with the increase severity judged by NIHSS score as well as size of stroke in NCCT-head. Therefore D-dimer values in stroke constitutes an important parameter in the evaluation of stroke specially its severity.

 
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