High D-Dimer Concentration Is a Significant Independent Prognostic Factor in Patients with Acute Large Vessel Occlusion Undergoing Endovascular Thrombectomy.

Abstract

To investigate prognostic factors that affect the modified Rankin Scale score at 3 months after onset of acute stroke in patients with large vessel occlusion who underwent endovascular thrombectomy. We retrospectively examined 87 consecutive patients who underwent endovascular cerebral thrombectomy for acute anterior circulation large vessel occlusion at Oita University Hospital and Nagatomi Neurosurgery Hospital from January 2014 to December 2020. Age, National Institutes of Health Stroke Scale score, and D-dimer concentration on admission were significant univariate prognostic factors related to modified Rankin Scale score at 3 months after stroke onset. Multivariate logistic regression analysis showed that D-dimer concentration was the only significant independent prognostic factor. The area under the receiver operating characteristic curve for D-dimer concentration and modified Rankin Scale score at 3 months was 0.715 (95% confidence interval 0.599-0.831); sensitivity and specificity were 60.6% and 80.0%, respectively, using a 1.9 μg/mL cutoff value. Prognosis may be worse in patients undergoing acute endovascular cerebral thrombectomy with high D-dimer concentration on admission. Other treatment options should be considered for these patients.