KADAR D-DIMER PLASMA DI STROK ISKEMIK AKUT

Ischemic stroke is a clinical sign of brain dysfunction or tissue damage caused by lack of blood flow to the brain that disrupts the blood and oxygen requirements in the brain tissue. In Indonesia, stroke is the third ranks after heart disease and malignancy. The prompt diagnosis can reduce morbidity and mortality. CT-scan is the gold standard, but it has some limitations that are difficult to recognize the early signs of ischemia on the first day and the cost of the related treatment is expensive. Because of these limitations, such case require another sign that is noninvasive, sensitive, specific, easier and cheaper to detect the presence of thrombus while the cause of ischemic stroke is D-dimer. This study was design to know the diagnostic value of plasma levels of D-dimer of the CT-scan in acute ischemic stroke by determination. A cross-sectional study was conducted, where forty patients with inclusion criteria were taken from The Neurology Department. The research was done at the Department of Clinical Pathology RSUP.H.Adam Malik/FK USU Medan. CT-scan as the gold standard for the D-dimer examination Plasma levels of D-dimer using latex agglutination method with a cut-off 500/mL. Statistical analysis using a 2×2 table to determine the sensitivity, specificity, positive predictive value, negative predictive value, prevalence and the likelihood ratio. The result found were as follows: sensitivity 77.7%, specificity 53.8%, positive predictive value 77.7%, negative predictive value 53.8%, prevalence 67.5%, likelihood ratio positive 1.74 and the likelihood ratio negative 0.43. Based on this study, the level plasma D-dimer could possibly can be used as an exclusion diagnostic in acute ischemic stroke case.