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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research The Journal of Society Medicine (JSOCMED)
Chairil Amin Batubara
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Short-Term Prognostic Model for Non-Traumatic Intracerebral Hemorrhage Patients: A Combination of Four Score, FUNC Score, and ICH Score Saragih, Nurvira Annisa; Alfansuri Kadri; Chairil Amin Batubara
Journal of Society Medicine Vol. 3 No. 1 (2024): January
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i1.114

Abstract

Introduction: Currently, the Functional Outcome in Patients With Primary Intracerebral Hemorrhage (FUNC) score, Full Outline of UnResponsiveness (FOUR) score, and Intracerebral Hemorrhage (ICH) score are utilized to predict outcomes in non-traumatic intracerebral hemorrhage (ICH) patients. The high mortality rate in non-traumatic ICH patients emphasizes the importance of scoring systems as predictive models for mortality prognosis. The aim of this study was to determine a short-term prognostic model for non-traumatic ICH patients by combining FUNC score, FOUR score, and ICH score. Method: This observational cohort study took place at the neurology ward and Intensive Care Unit of RSUP H. Adam Malik – Medan, from March to September 2023. Subjects meeting the study criteria were observed for 30 days to assess short-term outcomes (mortality). Multivariate logistic regression analysis was then conducted for the combined scores. Results: Significant effects were found between FUNC score, FOUR score, and ICH score on short-term mortality in non-traumatic ICH patients, each with a p-value < 0.001. However, the multivariate logistic regression analysis yielded statistically non-significant results (p > 0.05). Conclusion: While FUNC, FOUR, and ICH scores individually show a significant correlation with short-term mortality in non-traumatic ICH patients, their combination is ineffective for predicting mortality in this group.
Stratifying Neurological Severity in Acute Ischemic Stroke: The Independent and Combined Prognostic Value of Admission D-Dimer and High-Sensitivity C-Reactive Protein Syufriyadi DS; Zulfikar Lubis; Chairil Amin Batubara
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1396

Abstract

Background: Early risk stratification in acute ischemic stroke (AIS) is critical for optimizing patient management. The roles of inflammation and thrombosis in stroke pathophysiology suggest that high-sensitivity C-reactive protein (hs-CRP) and D-Dimer may serve as valuable prognostic biomarkers. This study aimed to evaluate the independent and combined value of admission D-Dimer and hs-CRP levels for predicting neurological severity in AIS patients. Methods: We conducted a prospective, cross-sectional study at Haji Adam Malik General Hospital, Medan, Indonesia, involving 60 consecutive AIS patients. Neurological severity was assessed upon admission using the National Institutes of Health Stroke Scale (NIHSS), with patients categorized into moderate (NIHSS 5-18) and severe (NIHSS >18) groups. Plasma D-Dimer and serum hs-CRP levels were quantified. Statistical analyses included the Mann-Whitney U test, Spearman's correlation, Receiver Operating Characteristic (ROC) curve analysis, and multivariate logistic regression to determine the independent predictive value of the biomarkers. Results: Of the 60 patients, 31 (51.7%) were classified as having severe stroke. Both D-Dimer and hs-CRP levels were significantly higher in the severe group compared to the moderate group (D-Dimer: median 3220 ng/mL vs. 670 ng/mL, P<0.001; hs-CRP: median 5.6 mg/dL vs. 0.9 mg/dL, P<0.001). ROC analysis demonstrated strong predictive performance for severe stroke, with an Area Under the Curve (AUC) of 0.89 (95% CI: 0.81-0.97) for D-Dimer and 0.83 (95% CI: 0.72-0.94) for hs-CRP. A combined model incorporating both biomarkers yielded a superior AUC of 0.92 (95% CI: 0.85-0.99). In multivariate logistic regression, both elevated D-Dimer (Odds Ratio [OR]: 6.8, 95% CI: 2.1-22.5, P=0.001) and hs-CRP (OR: 4.5, 95% CI: 1.5-13.8, P=0.008) remained independent predictors of severe stroke after adjusting for age and gender. Conclusion: Admission levels of D-Dimer and hs-CRP are powerful, independent prognostic markers for neurological severity in patients with acute ischemic stroke. Their use, particularly in combination, could enhance early risk stratification and guide clinical decision-making.
Stratifying Neurological Severity in Acute Ischemic Stroke: The Independent and Combined Prognostic Value of Admission D-Dimer and High-Sensitivity C-Reactive Protein Syufriyadi DS; Zulfikar Lubis; Chairil Amin Batubara
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1396

Abstract

Background: Early risk stratification in acute ischemic stroke (AIS) is critical for optimizing patient management. The roles of inflammation and thrombosis in stroke pathophysiology suggest that high-sensitivity C-reactive protein (hs-CRP) and D-Dimer may serve as valuable prognostic biomarkers. This study aimed to evaluate the independent and combined value of admission D-Dimer and hs-CRP levels for predicting neurological severity in AIS patients. Methods: We conducted a prospective, cross-sectional study at Haji Adam Malik General Hospital, Medan, Indonesia, involving 60 consecutive AIS patients. Neurological severity was assessed upon admission using the National Institutes of Health Stroke Scale (NIHSS), with patients categorized into moderate (NIHSS 5-18) and severe (NIHSS >18) groups. Plasma D-Dimer and serum hs-CRP levels were quantified. Statistical analyses included the Mann-Whitney U test, Spearman's correlation, Receiver Operating Characteristic (ROC) curve analysis, and multivariate logistic regression to determine the independent predictive value of the biomarkers. Results: Of the 60 patients, 31 (51.7%) were classified as having severe stroke. Both D-Dimer and hs-CRP levels were significantly higher in the severe group compared to the moderate group (D-Dimer: median 3220 ng/mL vs. 670 ng/mL, P<0.001; hs-CRP: median 5.6 mg/dL vs. 0.9 mg/dL, P<0.001). ROC analysis demonstrated strong predictive performance for severe stroke, with an Area Under the Curve (AUC) of 0.89 (95% CI: 0.81-0.97) for D-Dimer and 0.83 (95% CI: 0.72-0.94) for hs-CRP. A combined model incorporating both biomarkers yielded a superior AUC of 0.92 (95% CI: 0.85-0.99). In multivariate logistic regression, both elevated D-Dimer (Odds Ratio [OR]: 6.8, 95% CI: 2.1-22.5, P=0.001) and hs-CRP (OR: 4.5, 95% CI: 1.5-13.8, P=0.008) remained independent predictors of severe stroke after adjusting for age and gender. Conclusion: Admission levels of D-Dimer and hs-CRP are powerful, independent prognostic markers for neurological severity in patients with acute ischemic stroke. Their use, particularly in combination, could enhance early risk stratification and guide clinical decision-making.
Co-Authors Kadri, Alfansuri Saragih, Nurvira Annisa Syufriyadi DS Zulfikar Lubis