Multinominal association of serum D dimer levels with early adverse Outcomes among patients with isolated traumatic brain injury: prospective observational study at in uganda

Introduction Traumatic Brain injuries are remaining leading cause of morbidity and mortality in global, particularly in low- and middle-income countries. serum d dimer has emerged as potential biomarker of coagulation and fibrinolysis abnormalities among patients with isolated traumatic brain injury. However, its role in predicting outcomes in patients with isolated TBI is not well Objective This study aimed to determine serum D-dimer levels and assess their association with early adverse outcomes in patients with ITBI. Methods A hospital-based prospective cohort study was conducted from May to August 2025. We enrolled 98 adult patients with ITBI. Serum D-dimer levels were measured at admission, and patients were followed for 30 days. Outcomes were assessed using the Glasgow Outcome Scale (GOS) and the incidence of in-hospital complications. Data were analyzed using multinomial logistic regression to determine associations, adjusting for age and sex. Results The majority of participants were male (74.5%), with road traffic accidents as the leading cause of injury (51%). Elevated serum D-dimer (≥ 0.5 mg/L FEU) was observed in 73.5% of patients. At 30 days, 21.4% had unfavorable outcomes (severe disability or death). Elevated D-dimer was significantly associated with poor neurological recovery, with an adjusted Relative Risk Ratio (aRRR) of 6.0 for both moderate and severe disability. It was also strongly associated with seizures (aRRR = 5.22, 95% CI: 1.49–18.32) and aspiration pneumonia (aRRR = 19.96, 95% CI: 2.44–163.65). Conclusion Elevated serum D-dimer is common in ITBI and is a strong, independent predictor of poor neurological outcomes and specific complications. Incorporating D-dimer testing into the initial assessment of ITBI patients can serve as a valuable prognostic tool to guide timely interventions and improve risk stratification, particularly in resource-limited settings like Uganda.