Association between D-dimer concentrations and Glasgow Coma Scale in patients with hemorrhagic stroke

Abstract Objective: We aimed to evaluate the association between D-dimer concentrations and Glasgow Coma Scale (GCS), and examine any effect modifiers in patients with hemorrhagic stroke. Methods: A total of 627 participants with complete data were included in the final analysis. Results: The median of D-dimer concentration was 142.0 ng/ml (interquartile range: 60.0-273.5). The mean (SD) of age, GCS levels and D-dimer concentrations after transformations (BOXCOX method) were 61.0 years (12.0), 13.6 (2.5), and 8.5 ng/ml (4.3), respectively. Compared with participants with severe GCS scores (<9), those with mild (≥13) (β= -1.37; 95%CI: -2.67, -0.08) and moderate GCS scores (9≤GCS <13) (β= -1.64; 95%CI: -3.11, -0.16) had significantly lower D-dimer levels. Consistently, significantly lower D-dimer levels were found in participants with mild or moderate GCS scores (GCS ≥9; β= -1.43; 95%CI: -2.71, -0.15) compared with those with severe GCS scores (GCS <9). In the stratified analysis, a stronger inverse association between GCS categories (≥9 vs. <9) and D-dimer concentrations was observed in participants with lower platelet count (<194 *10^9/L vs. ≥194 *10^9/L; P for interaction =0.017). Conclusion: There was an inverse association between GCS and D-dimer concentrations among patients with hemorrhagic stroke, especially in participants with lower platelet counts.