JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (5): 612-616.doi: 10.3969/j.issn.1674-8115.2021.05.008

• Clinical research • Previous Articles     Next Articles

Evaluative value of plasma fibrin degradation product in early prognosis of patients with hemorrhagic stroke

Xu-guang CHEN(), Sheng-yi SHI, Lan HU, Yu CHEN, Yi-ming LU, Jing YE()   

  1. Department of Emergency, North Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201800, China
  • Online:2021-05-28 Published:2021-05-27
  • Contact: Jing YE E-mail:johncxg@126.com;carlionje8@126.com
  • Supported by:
    National Natural Science Foundation of China(91749126);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20161408)

Abstract: Objective

·To investigate the value of plasma fibrin degradation product (FDP) in assessing the risk of death within 14 d after hemorrhagic stroke (HS) onset.

Methods

·The general information, baseline laboratory parameters, surgical conditions and 14-day prognosis information of the patients with HS admitted to the Department of Emergency, North Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from May 1, 2017 to May 1, 2020 were retrospectively studied to analyze the factors associated with the patients' 14-day prognosis, and multivariate Logistic regression analysis was performed. The patients were then divided into intracerebral hemorrhage (ICH) group, primary intraventricular hemorrhage (PIVH) group and subarachnoid hemorrhage (SAH) group; the ICH group was divided into four subgroups, i.e., simple hematoma subgroup, ICH+intraventricular hemorrhage (IVH) subgroup, ICH+SAH subgroup, and ICH+IVH+SAH subgroup. Differences in the plasma FDP level between the patients who died and those who survived within 14 d were analysed separately for each group and subgroup.

Results

·A total of 606 patients with HS were included, with an average age of (58.9 ± 15.1) years, including 405 males and 201 females. There were 493 cases in the ICH group, 32 cases in the PIVH group and 81 cases in the SAH group; in the ICH group, 254 cases were in the simple hematoma subgroup, 142 cases were in the ICH+IVH subgroup, 49 cases were in the ICH+SAH subgroup and 48 cases were in the ICH+IVH+SAH subgroup. A total of 124 patients received surgical treatment. Eighty-five patients died within 14 d of onset. The plasma FDP level [2.07 (0.92, 5.65) μg/mL] was significantly higher in the patients who died within 14 d compared with those who survived [1.12 (0.70, 2.23) μg/mL] (P=0.000), and multivariate Logistic regression analysis showed that plasma FDP>2.78 μg/mL was an independent risk factor for death within 14 d (OR=2.564, P=0.001). Group analysis revealed that the plasma FDP level of the dead patients were significantly higher than those of the surviving patients in both the ICH group [2.09 (1.00, 5.34) μg/mL vs 1.06 (0.70, 1.86) μg/mL, P=0.000] and the PIVH group [4.25 (1.49, 5.91) μg/mL vs 1.20 (0.64, 2.30) μg/mL, P=0.041]. Subgroup analysis revealed that in the ICH+IVH subgroup, the plasma FDP level of the dead patients [2.09 (1.00, 5.58) μg/mL] was significantly higher than that of the surviving ones [1.26 (0.90, 2.21) μg/mL, P = 0.027].

Conclusion

·Plasma FDP>2.78 μg/mL may predict a higher risk of death within 14 d in the patients with HS, especially in those with PIVH or ICH combined with IVH.

Key words: hemorrhagic stroke (HS), fibrin degradation product (FDP), prognosis, intracerebral hemorrhage (ICH), intraventricular hemorrhage (IVH)

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