D-dimer/albumin ratio is a prognostic marker for patients with aneurysmal subarachnoid hemorrhage-retrospective research

Abstract

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a serious neurological disorder with limited treatment options and very little is known about its pathophysiology. And there are few available objective tools for predicting the clinical prognosis of aSAH patients and further aiding in directing clinical therapeutic programs. This study aimed to evaluate whether the raised serum D-dimer/albumin ratio (DAR) could reflect disease severity and predict clinical outcomes after aSAH.Methods: A total of 178 patients with aSAH were included in this retrospective study. Collected data included demographics; clinical severity of aSAH (WFNS scale and Hunt-Hess scale), levels of D-dimer, albumin, c-reactive protein (CRP), leukocyte counts, mRS on admission; and three-month prognosis. Clinical prognosis was dichotomized into favorable outcome (mRS ≤ 2) and unfavorable outcome (mRS ≥ 3). And the predictive ability of DAR for aSAH prognosis was determined by Receiver Operating Characteristic (ROC) Curve analysis.Results: The serum DAR showed a strong positive correlation with disease severity. Univariate analysis revealed that DAR, WFNS grade, Hunt-Hess grade, delayed cerebral infarction (DCI), age, neutrophil-to-lymphocyte ratio (NLR), and c-reactive protein/albumin ratio (CAR) were associated with unfavorable clinical outcome. Multivariate regression analysis further revealed that elevated DAR could predict poor prognosis after correcting for WFNS grade, Hunt-Hess grade, DCI, age, NLR, and CRP/albumin ratio. The receiver operating characteristic curve result demonstrated that DAR was a comparable predictor for clinical outcome of aSAH in comparison with NLR and CAR.Conclusion: DAR was d promising objective tool for aSAH patients. Hight content DAR was associate with disease severity and unfavorable short-term prognosis.