Predictors of 30-day mortality and the risk of recurrent systemic thromboembolism in cancer patients suffering acute ischemic strokeReport as inadecuate




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Background

Stroke in cancer patients is not rare but is a devastating event with high mortality. However, the predictors of mortality in stroke patients with cancer have not been well addressed. D-dimer could be a useful predictor because it can reflect both thromboembolic events and advanced stages of cancer.

Aim

In this study, we evaluate the possibility of D-dimer as a predictor of 30-day mortality in stroke patients with active cancer.

Methods

We included 210 ischemic stroke patients with active cancer. The 30-day mortality data were collected by reviewing medical records. We also collected follow-up D-dimer levels in 106 50% participants to evaluate the effects of treatment response on D-dimer levels.

Results

Of the 210 participants, 30-day mortality occurred in 28 13% patients. Higher initial NIHSS scores, D-dimer levels, and CRP levels as well as frequent cryptogenic mechanism, systemic metastasis, multiple vascular territory lesion, hemorrhagic transformation, and larger infarct volume were related to 30-day mortality. In the multivariate analysis, D-dimer adjusted OR aOR = 2.19; 95% CI, 1.46–3.28, P < 0.001 predicted 30-day mortality after adjusting for confounders. The initial NIHSS score aOR = 1.07; 95% CI, 1.00–1.14, P = 0.043 and hemorrhagic transformation aOR = 3.02; 95% CI, 1.10–8.29, P = 0.032 were also significant independent of D-dimer levels. In the analysis of D-dimer changes after treatment, the mortality group showed no significant decrease in D-dimer levels, despite treatment, while the survivor group showed the opposite response.

Conclusions

D-dimer levels may predict 30-day mortality in acute ischemic stroke patients with active cancer.



Author: Ki-Woong Nam , Chi Kyung Kim , Tae Jung Kim, Sang Joon An, Kyungmi Oh, Heejung Mo, Min Kyoung Kang, Moon-Ku Han, Andrew M. Demchu

Source: http://plos.srce.hr/



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