Clinical value of d-dipolymer levels in NaSAH patients

Ref: Zheng J, et alWorld Neurosurg2018 Jun;114:e1161-e1167doi: 10.1016/j.wneu.2018.03.165Epub 2018 Mar 31.)non-aneurystic cobweb subcavity hemorrhage, NaSAH) is more common in clinical practiceHowever, there is little information on assessing the risk of prognosis in Patients with NaSAH; the exact mechanism by which d-dipolymer levels affect clinical performance in Patients with NaSAH is not clearJianfeng Zheng of The First Hospital of Chongqing Medical University, who studied whether d-dipolymer levels were associated with complications and prognosis in NaSAH patients, was published in the June 2018 issue of World Neurosurgerythe retrospective study collected data on 92 NaSAH patients between February 2013 and May 2017Analysis of patients' clinical symptoms, radioimaging performance, laboratory test results, complications and prognosisThe patients were divided into the subcavity hemorrhage (PM-SAH) group around the central brain and the subcavity haemorrhage (NPM-SAH) group around the central brainThe routine blood samples of NaSAH patients were collected after admission to hospital, the d-dipolymer amount was detected within 2 hours, and the d-dipolymer and 0.55 mg/ml were set as elevatedAccording to the d-dimpolymer value, the NPM-SAH group was further divided into the NPM-elevated group and the NPM-normal groupStatistical analysis compared the differences between the NPM-SAH and the PM-SAH group and the NPM-SAH group and the NPM-normal groupstudy found that the incidence of complications in the NPM-SAH group was higher than that of the PM-SAH group, including early hydrocephalus, delayed cerebral ischemia, cerebrovascular spasms, pneumonia and hyponatremia; Further analysis showed that the incidence of complications in the NPM-elevated group was higher than in the NPM-normal group, especially the Risk of shunt-dependent hydrocephalus and pneumonia in the NPM-elevated groupIn addition, patients in the NPM-elevated group developed neurological disabilities and even died;the d-dipolymer content in the PM-SAH group was significantly lower than in the NPM-SAH group, but the d-dipolymer volume in most patients was within the normal range The multivariate analysis showed that the increase d-dipolymer level at admission was significantly related to the higher incidence of complications in NPM-SAH patients In the past, NaSAH was determined based on cerebrovascular imaging, pm-SAH and NPM-SAH were determined in conjunction with the SAH patterns shown in CT scans, and misclassification may occur due to subjective judgment by neurosurgeons Therefore, detecting d-dimpolymer content facilitates rapid differential diagnosis between NPM-SAH and PM-SAH Patients with normal d-dipolymer volume have a good clinical prognosis, while patients with elevated d-d-dipolymer levels tend to have more complications Therefore, d-dimpolymer content testing is beneficial to patients for active personalized treatment.