See the published version of this article at BMC Neurology.
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Research article
Xu Yang
Nanchong Centre Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Neurology.
Objectives: Pneumonia is related to poor prognosis in acute ischemic stroke (AIS), and its risk might be higher in atrial fibrillation (AF) related AIS with elevated plasma D-dimer. The aim of our study was to investigate the prognostic value of D-dimer for predicting clinical outcome of AF-related AIS with pneumonia.
Method: AF-related AIS patients with pneumonia were prospectively enrolled. Receiver operating characteristic (ROC) curve was used to determine the optimal D-dimer point for 3-month mortality and death/severe disability. The associations between the D-dimer and 3-month mortality and death/severe disability were assessed by multivariable logistic regression analysis.
Results: A total of 415 patients were enrolled in this study. ROC curve analysis showed that the optimal cut point of D-dimer for 3-month death/severe disability and mortality were D-dimer≥2.35mg/l and D-dimer≥3.35mg/l, respectively. Multivariable logistic regression analysis showed that D-dimer≥2.35mg/l(OR 5.95, 95% CI: 3.09-11.45, P＜0.001), higher NIHISS score(OR:1.53, 95% CI: 1.38–1.68, P＜0.001) were associated with increased risk of 3-month death/severe disability), and anticoagulant was associated with decreased risk of death/severe disability (OR:0.16, 95% CI: 0.07-0.35, P＜0.001). Higher NIHISS score(OR:1.56, 95% CI: 1. .37–1.77, P＜0.001), higher age(OR 1.06, 95% CI: 1.01–1.11, P=0.019), D-dimer≥3.35mg/l (OR 7.85, 95% CI: 3.21-19.21, P=0.001)were associated with increased risk of 3-month mortality.
Conclusions: AF-related AIS patients with concurrent high D-dimer and pneumonia increased risk of 3-month mortality and death/severe disability, plasma D-dimer may have predictive value in outcome after AF-related AIS with pneumonia.
Keywords
Acute ischemic stroke, Atrial fibrillation, D-dimer, Pneumonia, Outcome
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CURRENT STATUS: Published
Version 1
Posted 19 Aug, 2020
Published
On 27 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 07 Feb, 2021
Review #2 received
Received 31 Jan, 2021
Reviewer #2 agreed
On 27 Jan, 2021
Review #1 received
Received 14 Nov, 2020
Reviewer #1 agreed
On 25 Oct, 2020
Reviewers invited
Invitations sent on 31 Aug, 2020
Editor invited
On 18 Aug, 2020
Editor assigned
On 10 Aug, 2020
First submitted
On 09 Aug, 2020
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On 09 Aug, 2020
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This preprint is under consideration at BMC Neurology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Xu Yang
Nanchong Centre Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 19 Aug, 2020
Published
On 27 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 07 Feb, 2021
Review #2 received
Received 31 Jan, 2021
Reviewer #2 agreed
On 27 Jan, 2021
Review #1 received
Received 14 Nov, 2020
Reviewer #1 agreed
On 25 Oct, 2020
Reviewers invited
Invitations sent on 31 Aug, 2020
Editor invited
On 18 Aug, 2020
Editor assigned
On 10 Aug, 2020
First submitted
On 09 Aug, 2020
Submission checks complete
On 09 Aug, 2020
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Neurology.
Objectives: Pneumonia is related to poor prognosis in acute ischemic stroke (AIS), and its risk might be higher in atrial fibrillation (AF) related AIS with elevated plasma D-dimer. The aim of our study was to investigate the prognostic value of D-dimer for predicting clinical outcome of AF-related AIS with pneumonia.
Method: AF-related AIS patients with pneumonia were prospectively enrolled. Receiver operating characteristic (ROC) curve was used to determine the optimal D-dimer point for 3-month mortality and death/severe disability. The associations between the D-dimer and 3-month mortality and death/severe disability were assessed by multivariable logistic regression analysis.
Results: A total of 415 patients were enrolled in this study. ROC curve analysis showed that the optimal cut point of D-dimer for 3-month death/severe disability and mortality were D-dimer≥2.35mg/l and D-dimer≥3.35mg/l, respectively. Multivariable logistic regression analysis showed that D-dimer≥2.35mg/l(OR 5.95, 95% CI: 3.09-11.45, P＜0.001), higher NIHISS score(OR:1.53, 95% CI: 1.38–1.68, P＜0.001) were associated with increased risk of 3-month death/severe disability), and anticoagulant was associated with decreased risk of death/severe disability (OR:0.16, 95% CI: 0.07-0.35, P＜0.001). Higher NIHISS score(OR:1.56, 95% CI: 1. .37–1.77, P＜0.001), higher age(OR 1.06, 95% CI: 1.01–1.11, P=0.019), D-dimer≥3.35mg/l (OR 7.85, 95% CI: 3.21-19.21, P=0.001)were associated with increased risk of 3-month mortality.
Conclusions: AF-related AIS patients with concurrent high D-dimer and pneumonia increased risk of 3-month mortality and death/severe disability, plasma D-dimer may have predictive value in outcome after AF-related AIS with pneumonia.
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