A retrospective cohort study on a novel marker to predict the severity and prognosis of acute cerebral venous thrombosis: D-dimer to fibrinogen ratio.

IF 2.6 4区医学 Q2 HEMATOLOGY Thrombosis Journal Pub Date : 2024-10-30 DOI:10.1186/s12959-024-00664-x

Duo Lan, Mengqi Wang, Xiaoming Zhang, Xiangqian Huang, Naiqi Liu, Xiangyu Ren, Kun Fang, Da Zhou, Ran Meng

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Abstract

Background and aim: The D-dimer to fibrinogen ratio (DFR) represents an emerging and significant clinical biomarker. However, its correlation with cerebral venous thrombosis (CVT) remains underexplored. This retrospective cohort study aims to elucidate the association between DFR values and the severity and prognosis of CVT.

Methods: Severe CVT was defined as the presence of at least 1 of the following risk factors: mental status disorder, coma state, intracranial cerebral hemorrhage, or thrombosis of the deep cerebral venous system. The modified Rankin Scale was utilized to assess functional outcomes. DFR measurements were obtained within 24 h of hospital admission. Logistic regression analysis was employed to determine the prognostic significance of DFR. After Bonferroni correction, a two-tailed P value < 0.017 (0.05/3) was considered statistically significant.

Result: A total of 196 patients were included in the study, among whom 85 patients were diagnosed with severe CVT, and 35 and 14 patients experienced short-term and long-term adverse outcomes, respectively. Receiver operating characteristic curve analysis demonstrated that DFR has predictive value for severe CVT, poor short-term and long-term outcomes, with area under the curve values of 0.690 [95% CI: 0.617-0.764, P < .001], 0.773 [95% CI: 0.701-0.845, P < .001], and 0.754 [95% CI: 0.619-0.886, P = .002], respectively. DFR ≥ 0.253 was identified as a significant predictor of severe CVT [adjusted odds ratio (aOR) (95% CI): 2.03 (1.10-3.75), P = .024]. Additionally, DFR ≥ 0.322 and DFR ≥ 0.754 were significantly associated with poor short-term outcomes at discharge [aOR (95% CI): 2.63 (1.43-4.76), P = .002] and poor long-term outcomes at 12 months [aOR (95% CI): 2.86 (1.32-6.25), P = .008], respectively.

Conclusion: Elevated DFR is associated with increased severity of CVT. Additionally, higher DFR levels can predict poorer clinical outcomes in CVT.

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一项关于预测急性脑静脉血栓严重程度和预后的新型标记物的回顾性队列研究：D-二聚体与纤维蛋白原比率。

背景和目的：D-二聚体与纤维蛋白原比率（DFR）是一种新兴的重要临床生物标志物。然而，其与脑静脉血栓形成（CVT）的相关性仍未得到充分探讨。这项回顾性队列研究旨在阐明 DFR 值与 CVT 的严重程度和预后之间的关系：严重 CVT 的定义是至少存在以下一种危险因素：精神状态障碍、昏迷状态、颅内脑出血或脑深静脉系统血栓形成。采用改良兰金量表评估功能结果。DFR测量值在入院后24小时内获得。采用逻辑回归分析来确定DFR的预后意义。经过Bonferroni校正后，结果为双尾P值：研究共纳入 196 例患者，其中 85 例患者被诊断为重度 CVT，分别有 35 例和 14 例患者出现短期和长期不良预后。接收者操作特征曲线分析表明，DFR 对重度 CVT、短期和长期不良预后具有预测价值，曲线下面积值为 0.690 [95% CI：0.617-0.764，P 结论：DFR 升高与重度 CVT、短期和长期不良预后相关：DFR 升高与 CVT 严重程度增加有关。此外，较高的 DFR 水平可预测较差的 CVT 临床预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thrombosis Journal Medicine-Hematology

CiteScore

3.80

自引率

3.20%

发文量

审稿时长

16 weeks

期刊介绍： Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis. Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.