Cognitive impairment after traumatic brain injury (TBI) is a main source of morbidity for affected individuals, their family members, and their community. There are numerous serum biomarkers, which are elevated after TBI; one of these is D-dimer. Several studies have related that trauma-related coagulopathy, marked by elevated D-dimer levels, is associated with poor prognosis. The aim of this study was to find if there is a correlation between elevated serum levels of D-dimer and impairment of final cognitive outcome in case suffering of Moderate TBI. Patients and method This is a prospective cohort study with a random sample of 87 patients suffering from moderate TBI. Serum level of D-dimer was requested for all cases after confirming the diagnosis of moderate TBI with post-traumatic GCS 9–12. Head trauma treatment protocols were followed according to each case diagnosis and then at the time of discharge cognitive outcome was assessed for all cases. Neurocognition was assessed by Montreal cognitive assessment-Basic (MoCA-B). Eighty-seven cases were included in this trial with a mean age 28 years. 48.3% of cases were treated conservatively while the remaining 51.7% needed surgical interventions for different pathologies. Seventy-five cases had elevated levels of serum D-dimer (86.2%) whereas only 12 cases have within normal levels (13.8%). A twofold increase in the serum D-dimer level was found in 41% of cases, while 34.5% of cases had three- to sixfold increases, and 10% of cases had more than sixfold increase. The mean MoCA-B score was 24 points (range 13–27). Correlating the D-dimer levels statistically with the MoCA scores, age, admission and discharge GCS, and durations of hospital stay did not show any statistical significance with any of these variables. The role played by D-dimer in the pathophysiology of cognitive deficits and its correlation with post moderate TBI cognitive outcome was not proven.

中文翻译：

---

血清D-二聚体水平对中度颅脑损伤患者认知结局的影响

脑外伤（TBI）后的认知障碍是受影响个人，其家庭成员和社区发病的主要来源。血清生物标志物很多，在TBI后升高。D-二聚体就是其中之一。几项研究表明，以D-二聚体水平升高为特征的创伤相关性凝血病与不良预后有关。这项研究的目的是发现在患有中度TBI的患者中，血清D-二聚体水平升高与最终认知结局受损之间是否存在相关性。患者和方法这是一项前瞻性队列研究，随机抽取87名患有中度TBI的患者。在确定创伤后GCS 9-12诊断为中度TBI后，要求所有病例的血清D-二聚体水平。根据每个病例的诊断遵循头部创伤治疗方案，然后在出院时评估所有病例的认知结局。神经认知通过蒙特利尔认知评估-基本（MoCA-B）进行评估。该试验纳入了87例，平均年龄28岁。48.3％的患者采用保守治疗，其余51.7％的患者需要针对不同病理情况进行手术干预。75例血清D-二聚体水平升高（86.2％），而只有12例血清D-二聚体水平处于正常水平（13.8％）。41％的患者的血清D-二聚体水平增加了两倍，而34.5％的患者的血清D-二聚体水平增加了三至六倍，而10％的患者的血液中D-二聚体水平增加了六倍以上。MoCA-B平均得分为24分（范围13–27）。将D-二聚体水平与MoCA分数，年龄，对于这些变量，GCS的住院和出院时间以及住院时间均无统计学意义。D-二聚体在认知缺陷的病理生理中所起的作用及其与中度TBI认知预后的相关性尚未得到证实。