D-Dimer Levels and NIHSS as Prognostic Predictors in Elderly Patients with Cerebral Infarction.

Objective: This study evaluates the relationship between D-dimer levels and NIHSS scores with prognosis in elderly patients with cerebral infarction.

Methods: This study was a retrospective study that included 112 elderly patients with cerebral infarction admitted to our hospital from January 2022 to December 2023. The modified Rankin Scale (mRS) was used to assess the prognosis at six-month follow-up, and patients were divided into two groups: good prognosis (mRS 0-2) and poor prognosis (mRS 3-6). Detailed data collection and statistical analysis were conducted, including descriptive statistics of baseline data, correlation analysis between D-dimer and NIHSS scores, and multivariate logistic regression analysis to identify independent risk factors for poor prognosis.

Results: Patients in the poor prognosis group had significantly higher age, BMI, proportions of smoking history, alcohol consumption history, transient ischemic attack (TIA) history, atrial fibrillation history, admission NIHSS scores, and D-dimer levels compared to the good prognosis group (P<0.05). In addition, there were significant differences in D-dimer levels among patients with mild (NIHSS 1-4), moderate (NIHSS 5-14), and severe (NIHSS≥15) strokes (P<0.001), and D-dimer levels were significantly positively correlated with NIHSS scores (r=0.58, P<0.001). Multivariate logistic regression analysis showed that D-dimer levels, admission NIHSS scores, age, atrial fibrillation, and TIA history were independent predictors of poor prognosis (P<0.05). ROC curve analysis showed that the AUC of D-dimer in predicting poor prognosis was 0.76 (95% CI: 0.67-0.85), with a sensitivity of 72% and specificity of 74%.

Conclusion: D-dimer and NIHSS showed a significant positive correlation (r=0.58, P<0.001), with an AUC of 0.76 for predicting poor prognosis. Independent risk factors included age, atrial fibrillation, and a history of TIA. These findings support the use of D-dimer as a critical biomarker in risk stratification for elderly stroke patients.