Research Article
Correlation of Plasma D-Dimer Levels with Stroke Severity and Short-Term Outcome in Patients with Acute Ischemic Stroke: A Cross-Sectional Study
Kumar V*, Siddiqui A and Kumar S
Department of Medicine All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
*Corresponding author: Dr. Vijay Kumar, Department of Medicine All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India. E-mail Id: vk1994@gmail.com
Article Information:Submission: 22/04/2026; Accepted: 14/05/2026; Published: 16/05/2026
Copyright: © 2026 Kumar V, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Stroke is a leading cause of death and disability globally, with ischemic stroke accounting for approximately 85% of all cases. While clinical scales like the NIHSS and mRS are widely used for early assessment and prognosis, biochemical markers such as D-dimer are gaining interest for their potential to enhance prognostication. Elevated D-dimer levels, a fibrin degradation product, indicate thrombotic activity and may correlate with stroke severity, etiology, and functional outcomes.
Methods: A total of 140 adult patients (≥18 years) with confirmed acute ischemic stroke, admitted within 48 hours of symptom onset, were includedwas to determine the correlation between admission plasma D-dimer levels and stroke severity using the NIHSS, also association between initial D-dimer and mRSat 4 weeks. Clinical data, risk factors, NIHSS at admission, and plasma D-dimer levelswere collected. Functional outcome was assessed at 4 weeks using the mRS. Spearman’s correlation and chi-square tests were used, with p-values <0.05 considered statistically significant.
Results: 74.3% of patients had elevated D-dimer levels (>0.5 ug/mL). A statistically significant positive correlation was observed between D-dimer levels and NIHSS scores (Spearman’s ρ = 0.581, p < 0.001), indicating higher D-dimer correlates with greater stroke severity. Similarly, a significant positive correlation was found between D-dimer levels and mRS scores at 28 days (Spearman’s ρ = 0.601, p < 0.001), suggesting a link to poorer functional outcomes. Chi-square analyses further confirmed strong associations between elevated D-dimer and both increased stroke severity (χ²(1) = 28.3, p < 0.001) and poor functional outcomes (χ²(1) = 34.3, p < 0.001).
Conclusion: This study highlights a significant association between elevated plasma D-dimer levels and both the severity and short-term functional outcome of acute ischemic stroke. D-dimer can be used to complement clinical scales for early risk stratification, guiding acute management decisions, and predicting recovery trajectories.
• What is already known on this topic -D-dimer is recognized as a marker of thrombotic activity and stroke prognosis and its correlation with severity and outcome has been established in some studies.
• What this study adds -This study demonstrates a significant positive correlation between elevated D-dimer levels at admission and both increased stroke severity (NIHSS) and poorer short-term functional outcomes (mRS) in an Indian cohort confirming previous findings.
• How this study might affect research, practice or policy -D-dimer testing can be integrated into emergency stroke protocols for early risk stratification and guiding management. Future research can build on this by exploring serial D-dimer measurements and developing personalized stroke management models.
Methods: A total of 140 adult patients (≥18 years) with confirmed acute ischemic stroke, admitted within 48 hours of symptom onset, were includedwas to determine the correlation between admission plasma D-dimer levels and stroke severity using the NIHSS, also association between initial D-dimer and mRSat 4 weeks. Clinical data, risk factors, NIHSS at admission, and plasma D-dimer levelswere collected. Functional outcome was assessed at 4 weeks using the mRS. Spearman’s correlation and chi-square tests were used, with p-values <0.05 considered statistically significant.
Results: 74.3% of patients had elevated D-dimer levels (>0.5 ug/mL). A statistically significant positive correlation was observed between D-dimer levels and NIHSS scores (Spearman’s ρ = 0.581, p < 0.001), indicating higher D-dimer correlates with greater stroke severity. Similarly, a significant positive correlation was found between D-dimer levels and mRS scores at 28 days (Spearman’s ρ = 0.601, p < 0.001), suggesting a link to poorer functional outcomes. Chi-square analyses further confirmed strong associations between elevated D-dimer and both increased stroke severity (χ²(1) = 28.3, p < 0.001) and poor functional outcomes (χ²(1) = 34.3, p < 0.001).
Conclusion: This study highlights a significant association between elevated plasma D-dimer levels and both the severity and short-term functional outcome of acute ischemic stroke. D-dimer can be used to complement clinical scales for early risk stratification, guiding acute management decisions, and predicting recovery trajectories.
• What is already known on this topic -D-dimer is recognized as a marker of thrombotic activity and stroke prognosis and its correlation with severity and outcome has been established in some studies.
• What this study adds -This study demonstrates a significant positive correlation between elevated D-dimer levels at admission and both increased stroke severity (NIHSS) and poorer short-term functional outcomes (mRS) in an Indian cohort confirming previous findings.
• How this study might affect research, practice or policy -D-dimer testing can be integrated into emergency stroke protocols for early risk stratification and guiding management. Future research can build on this by exploring serial D-dimer measurements and developing personalized stroke management models.
Keywords:D-Dimer; Ischemic Stroke; NIHSS; Mrs; Stroke Prognosis; India