DFR in Evaluating Hemorrhagic Transformation After Mechanical Thrombectomy in Patients with Acute Cerebral Infarction

WEI Tongguo; CHEN Danxia; ZHONG Yu; ZHU Qinhui; XU Kunming

doi:10.3639/i.issn.2095-3097.2025.01.010

Abstract：Objective To investigate the value of D-dimer(D-D)/fibrinogen(FIB)ratio(DFR)in evaluating hemorrhagic transformation(HT)after mechanical thrombectomy in patients with acute cerebral infarction(ACI).Methods A total of 120 patients with acute cerebral infarction who underwent mechanical thrombectomy at our hospital from January 2021 to December 2023 were included.They were divided into an HT group(n=46)and a non-HT group(n=74)based on whether HT occurred within 3 days post-thrombectomy.D-D and FIB levels were measured using immunoturbidimetry,and DFR was calculated.The value of D-D,FIB,and DFR for predicting HT after thrombectomy was analyzed using ROC curves.Risk factors for HT were evaluated via multivariate Logistic regression.Results The HT group showed significantly higher D-D and DFR and lower FIB levels than the non-HT group(P<0.05).The AUC for predicting HT was 0.724(95%CI:0.679-0.774)for D-D,0.876(95%CI:0.826-0.921)for FIB,and 0.942(95%CI:0.892-0.987)for DFR.The HT group also had higher rates of smoking history,diabetes,elevated preoperative NIHSS scores,and postoperative systolic blood pressure compared to the non-HT group(P<0.05).Preoperative NIHSS score≥14 points(OR=2.524,95%CI:1.383-4.608),postoperative systolic blood pressure≥137 mmHg(OR=2.119,95%CI:1.236-3.633),D-D≥1.68 mg/L(OR=2.971,95%CI:1.637-5.392),FIB≤2.87 g/L(OR=3.238,95%CI:1.813-5.392),and DFR≥0.61(OR=4.023,95%CI:2.292-7.061)were identified as independent risk factors for HT.Conclusion High DFR is a significant risk factor for HT in ACI patients post-mechanical thrombectomy and can serve as a clinical marker for evaluation.