Dai Dapeng, Sun Yong, Zhang Hongwei, Li Aimin
Department of Neurosurgery, The First People's Hospital of Lianyungang, Lianyungang City, Jiangsu Province, 222000, People's Republic of China.
Int J Gen Med. 2025 Sep 11;18:5345-5353. doi: 10.2147/IJGM.S540186. eCollection 2025.
Hemorrhagic stroke (HS) represents one of the major causes of death in China. The research work focuses on the correlation between Glasgow Coma Scale (GCS) score and D-dimer level, and the role of modified factors such as platelet count in HS patients.
This was a cross-sectional study that was conducted at the First People's Hospital of Lianyungang, Lianyungang City, China. HS Patients were divided into three groups according to their GCS scores: GCS < 9 (severe, n = 43), 9 ≤ GCS < 13 (moderate, n = 97), and GCS ≥ 13 (mild, n = 487).
The analysis comprised 627 participants. D-dimer levels were 142.0 ng/mL on average. The average GCS score was 13.6, and the average age was 61.0 years. The three GCS groups showed significant differences in D-dimer concentrations, diastolic blood pressure (DBP), and systolic blood pressure (SBP) (P < 0.001, P = 0.028, and P = 0.005, respectively). Among severe GCS scores (<9), the D-dimer level was the highest at 237.0 ng/mL. After adjustment for possible confounders, the D-dimer concentrations were significantly lower in the moderate and mild GCS groups than in the severe group (P = 0.030 and P = 0.038, respectively). In the stratified analysis, the association between GCS categories and D-dimer levels was stronger among participants with low platelet counts (<194 × 10^9/L; P for interaction = 0.017).
This study reveals a significant inverse association between D-dimer levels and GCS scores in HS patients, especially those with lower platelet counts. Elevated D-dimer levels may reflect coagulation and fibrinolysis activation, contributing to worse outcomes. Clinically, more attention and monitoring should be paid to the HS patients with elevated D-dimer levels.
出血性卒中（HS）是中国主要的死亡原因之一。本研究工作聚焦于格拉斯哥昏迷量表（GCS）评分与D - 二聚体水平之间的相关性，以及血小板计数等修正因素在HS患者中的作用。
这是一项在中国连云港市第一人民医院开展的横断面研究。HS患者根据其GCS评分分为三组：GCS < 9（重度，n = 43）、9 ≤ GCS < 13（中度，n = 97）和GCS ≥ 13（轻度，n = 487）。
分析纳入627名参与者。D - 二聚体水平平均为142.0 ng/mL。平均GCS评分为13.6，平均年龄为61.0岁。三个GCS组在D - 二聚体浓度、舒张压（DBP）和收缩压（SBP）方面存在显著差异（分别为P < 0.001、P = 0.028和P = 0.005）。在重度GCS评分（<9）中，D - 二聚体水平最高，为237.0 ng/mL。在对可能的混杂因素进行调整后，中度和轻度GCS组的D - 二聚体浓度显著低于重度组（分别为P = 0.030和P = 0.038）。在分层分析中，血小板计数低（<194×10^9/L）的参与者中，GCS类别与D - 二聚体水平之间的关联更强（交互作用P = 0.017）。
本研究揭示了HS患者中D - 二聚体水平与GCS评分之间存在显著的负相关，尤其是血小板计数较低的患者。D - 二聚体水平升高可能反映凝血和纤溶激活，导致预后更差。临床上，应更加关注和监测D - 二聚体水平升高的HS患者。
