Serum D-dimer level as a predictor of neurological functional prognosis in cases of head injuries caused by road trafc accidents
Dublin Core
Title
Serum D-dimer level as a predictor of neurological functional prognosis in cases of head injuries caused by road trafc accidents
Subject
Neurological functional predictors, Serum D-dimer, Head injuries, Road trafc accidents
Description
Background: The number of trafc fatalities is declining in Japan; however, a large proportion of head injuries are still
attributable to trafc accidents. Severe head trauma may cause progressive and devastating coagulopathy owing to
exacerbated coagulation and fbrinolysis, which results in massive bleeding and poor patient outcomes. D-dimer is
a fbrinolytic marker, which remarkably increases in severe coagulopathy due to the exacerbated fbrinolytic system.
Because the degree of coagulopathy is associated with patient outcomes, the D-dimer level is a useful prognostic
predictor in patients with head trauma. However, the usefulness of D-dimer in cases of head trauma caused by road
trafc accidents remains inadequately explored. In this study, we investigated the relationship between D-dimer
levels and outcomes in head injuries caused by trafc accidents.
Methods: We extracted data on trafc injuries from Japan Neuro-Trauma Data Bank Project 2015, which is a prospective multicenter registry of head injuries. The analysis included 335 individuals with no missing data. The outcome
variable was the score of the Glasgow Outcome Scale (GOS), a neurological outcome index. The participants were categorized into the favorable outcome (GOS score≥4) and poor outcome (GOS score≤3) groups. The serum D-dimer
levels at the time of admission were divided into four categories at the quartiles, and the reference category was less
than the frst quartile (<17.4 µg/mL). We performed a logistic regression analysis with GOS as the dependent variable
and D-dimer as a predictor and performed a multivariate analysis that was adjusted for 10 physiological parameters.
Results: In the univariate analysis, all groups with serum D-dimer values≥17.4 μg/dL showed signifcantly poorer
outcomes than those of the reference group. In the multivariate analysis, after adjusting for other factors, D-dimer
levels≥89.3 μg/dL were an independent predictor of poor outcome.
Conclusion: After adjusting for physiological parameters, high serum D-dimer levels can be an independent factor
for predicting neurological prognosis in head trauma caused by road trafc accidents.
attributable to trafc accidents. Severe head trauma may cause progressive and devastating coagulopathy owing to
exacerbated coagulation and fbrinolysis, which results in massive bleeding and poor patient outcomes. D-dimer is
a fbrinolytic marker, which remarkably increases in severe coagulopathy due to the exacerbated fbrinolytic system.
Because the degree of coagulopathy is associated with patient outcomes, the D-dimer level is a useful prognostic
predictor in patients with head trauma. However, the usefulness of D-dimer in cases of head trauma caused by road
trafc accidents remains inadequately explored. In this study, we investigated the relationship between D-dimer
levels and outcomes in head injuries caused by trafc accidents.
Methods: We extracted data on trafc injuries from Japan Neuro-Trauma Data Bank Project 2015, which is a prospective multicenter registry of head injuries. The analysis included 335 individuals with no missing data. The outcome
variable was the score of the Glasgow Outcome Scale (GOS), a neurological outcome index. The participants were categorized into the favorable outcome (GOS score≥4) and poor outcome (GOS score≤3) groups. The serum D-dimer
levels at the time of admission were divided into four categories at the quartiles, and the reference category was less
than the frst quartile (<17.4 µg/mL). We performed a logistic regression analysis with GOS as the dependent variable
and D-dimer as a predictor and performed a multivariate analysis that was adjusted for 10 physiological parameters.
Results: In the univariate analysis, all groups with serum D-dimer values≥17.4 μg/dL showed signifcantly poorer
outcomes than those of the reference group. In the multivariate analysis, after adjusting for other factors, D-dimer
levels≥89.3 μg/dL were an independent predictor of poor outcome.
Conclusion: After adjusting for physiological parameters, high serum D-dimer levels can be an independent factor
for predicting neurological prognosis in head trauma caused by road trafc accidents.
Creator
Masahiro Asami, Shinji Nakahara, Yasufumi Miyake, Jun Kanda, Takahiro Onuki, Akira Matsuno and Tetsuya Sakamoto
Publisher
BMC Emergency Medicine
Date
(2022) 22:51
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Masahiro Asami, Shinji Nakahara, Yasufumi Miyake, Jun Kanda, Takahiro Onuki, Akira Matsuno and Tetsuya Sakamoto, “Serum D-dimer level as a predictor of neurological functional prognosis in cases of head injuries caused by road trafc accidents,” Repository Horizon University Indonesia, accessed April 4, 2025, https://repository.horizon.ac.id/items/show/4055.