Association of D-dimer and Fibrinogen Levels with Stroke Severity in Acute Ischemic Stroke Patients: A Cross-Sectional Study at a Tertiary Referral Hospital in Indonesia

Background Acute ischemic stroke remains a major cause of mortality and long-term disability worldwide. Early assessment of stroke severity is essential for prognostication and clinical decision-making. Hypercoagulability plays a crucial role in the pathophysiology of ischemic stroke. D-dimer and fibrinogen are widely available laboratory markers reflecting coagulation and fibrinolytic activity, yet their association with stroke severity in Indonesian populations has not been well established. This study aimed to evaluate the relationship between D-dimer and fibrinogen levels and the severity of acute ischemic stroke. Methods A prospective analytical observational study with a cross-sectional approach was conducted at Haji Adam Malik General Hospital, Medan, Indonesia, from October 2022 to March 2023. A total of 69 adult patients with confirmed acute ischemic stroke were enrolled using consecutive sampling. Stroke severity was assessed using the National Institutes of Health Stroke Scale and classified as moderate or severe. Blood samples were collected on admission to measure D-dimer and fibrinogen levels. Data were analyzed using SPSS v.26.0 Results Among the 69 patients, 50.7% were female, and the majority were aged 51–60 years. Median D-dimer levels were significantly higher in patients with severe stroke compared to those with moderate stroke severity (2060 ng/mL vs 620 ng/mL, p < 0.001). Fibrinogen levels were also significantly elevated in the severe group (425.05 mg/dL vs 349.2 mg/dL, p = 0.012). Both D-dimer and fibrinogen levels showed positive correlations with stroke severity scores, with D-dimer demonstrating a stronger correlation. Conclusions Elevated D-dimer and fibrinogen levels are significantly associated with increased severity of acute ischemic stroke. These findings suggest that both biomarkers may serve as practical and accessible indicators for early assessment of stroke severity in clinical settings. Further multicenter and longitudinal studies are warranted to evaluate their prognostic value and potential role in guiding therapeutic strategies.