Association of D-dimer Levels in Acute Ischaemic Stroke Patients at Tertiary Care Centre in Northern India: A Prospective Observational Study

Background D-dimer, a fibrin degradation product, has emerged as a potential biomarker in acute ischemic stroke (AIS) due to its association with thrombotic activity. This study aimed to evaluate the association between D-dimer levels and stroke severity, in-hospital outcomes, and functional status in AIS patients admitted to a tertiary care center. Methods This prospective observational study was conducted over one year and included 120 patients diagnosed with AIS. Demographic, clinical, and radiological data were recorded. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), while functional outcomes were evaluated with the modified Rankin Scale (mRS). D-dimer levels were measured on admission, and patients were followed through hospitalization. Statistical analyses included analysis of variance (ANOVA), t-tests, and Pearson correlation. Results The mean age of patients was 57.09±15.65 years, with a slight female predominance (62, 51.67%). Hypertension (87, 72.50%) and diabetes (44, 36.67%) were the most common comorbidities. Middle cerebral artery (MCA) territory stroke was the most frequent subtype (30, 25%), and 67 (55.83%) patients had severe stroke (NIHSS≥16). In-hospital mortality was observed in 36 (30%) cases, while 84 (70%) patients were discharged. Mean D-dimer levels increased with stroke severity: 46.30±79.72 mcg/dL in mild, 60.35±69.12 mcg/dL in moderate, and 195.84±268.98 mcg/dL in severe strokes (p<0.0001). Patients who died had significantly higher D-dimer levels (253.93±339.77 mcg/dL) compared to those discharged (84.14±103.76 mcg/dL; p=0.0043). D-dimer showed a strong positive correlation with NIHSS (r=0.873) and a moderate correlation with modified Rankin Scale (mRS) (r=0.367), both statistically significant. Conclusion Elevated D-dimer levels were significantly associated with stroke severity and poor in-hospital outcomes. These findings support the utility of D-dimer as a prognostic biomarker in AIS and suggest its potential role in early risk stratification.