Predictive Efficacy of D-dimer/Platelet Ratio for Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage in Elderly Patients
ZHANG Wengao
HE Jianchang
LIU Zhiguo
ZHANG Baoxu
ZHAO Zhihuang
WANG Jinfeng
YANG Xinyu
Abstract：Objective To analyze the predictive efficacy of D-dimer/platelet ratio(DPR)for delayed cerebral ischemia(DCI)after aneurysmal subarachnoid hemorrhage(aSAH)in elderly patients.Methods A total of 152 elderly patients with aSAH admitted to our hospital from May 2020 to May 2024 were selected as the research group,and then divided into the observation group(n=45)and the non-occurrence group(n=107)according to the occurrence of DCI.In addition,139 healthy physical examinees during the same period were selected as the control group.The levels of D-dimer(D-D)and platelet count(PLT)in peripheral blood of both groups were detected after admission,and the DPR ratio was calculated.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of DPR for DCI after aSAH in the elderly.Multivariate logistic regression analysis was used to explore the related factors for the occurrence of DCI after aSAH in the elderly.Results The levels of serum D-D and DPR in the observation group were higher than those in the control group,while the level of PLT was lower than that in the control group(P<0.05).The proportion of patients with Hunt-Hess grade≥3,serum D-D,DPR,white blood cell,hypoxia-inducible factor-1α(HIF-1α),interleukin-6(IL-6),prothrombin time(PT),and activated partial thromboplastin time(APTT)in the observation group were higher than those in the non-occurrence group,while the PLT level was lower in the observation group than in the non-occurrence group(P<0.01).The results of ROC curve showed that the area under the ROC curve(AUC)of DPR for predicting DCI after aSAH in the elderly was 0.901(95%CI:0.852,0.952).Multivariate logistic regression analysis showed that Hunt-Hess grade[OR(95%CI):2.721(1.647,4.494)],HIF-1α[OR(95%CI):2.349(1.553,3.552)],IL-6[OR(95%CI):2.106(1.466,3.027)]and DPR[OR(95%CI):3.504(1.890,6.497)]were related factors affecting the occurrence of DCI after aSAH in the elderly(P<0.01).Conclusions The abnormal increase of DPR in elderly patients with DCI after aSAH is a risk factor for DCI in elderly patients with aSAH.DPR is expected to be an effective index for predicting DCI in patients with aSAH.
Keywords：D-dimer/platelet ratiothe elderlyaneurysmal subarachnoid hemorrhagedelayed cerebral ischemiaHunt-Hess gradehypoxia-inducible factor-1αinterleukin-6
Publication Date：2025-08-13
Online Publishing Date：2025-08-26(First online date of this platform, not the publication date of the document)
Pages：5( 53-57 )