High intracranial pressure may be the initial inducer of elevated plasma D-dimer level after aneurysmal subarachnoid haemorrhage

Abstract

Objective: The plasma D-dimer has been regarded as a poor prognosis factor in aneurysmal subarachnoid haemorrhage (aSAH) patients, but the reason of elevated D-dimer level has not been revealed. In this study, we retrospectively explored the potential clinical parameters which might be related to D-dimer level and further attempted to explain the pathological process of D-dimer level elevation in aSAH patients. Patients and methods: The qualified patients with aSAH were recruited and treated in Sichuan Provincial People's Hospital from 1 October 2015 to 28 February 2018. All clinical data were collected, the blood samples were gathered on admission and the levels of D-dimer were detected by the clinical laboratory. The χ2-test, univariate and multiple linear regression analysis were used to seek the relationship between clinical variables and D-dimer level.Results: Total 98 aSAH patients were enrolled. The χ2-test showed a significant difference in clinical characteristics of gender, hyperlipidaemia and ICP between the patients with normal D-dimer level and the others with a high D-dimer level (p < .05). The univariate linear regression analysis and the multiple linear regression analysis showed the combined CCT and ICP were still significantly related to D-dimer level (p < .05). Conclusion: Besides the other related factors, the increased ICP was obviously associated with the elevated plasma D-dimer level. It may indicate that the high ICP acted as the initial role, then led to poor perfusion, even induced the microthrombosis and activated the fibrinolytic system, which eventually contributed to D-dimer level increasing in aSAH patients.