scholarly journals Correlation between Acute Stroke and Concentration of Creatine Kinase Myocardial Band, Troponin T, Hemoglobin, and Electroyltes

2018 ◽  
Vol 14 (1) ◽  
pp. 71-80
Author(s):  
Destika Fahrina ◽  
Puji Pinta Sinurat ◽  
Aldy Sjarifuddin Rambe

Currently, there were only a few studies regarding the correlation between concentration of creatine kinase-myocardial band (CKMB), troponin T, hemoglobin, and electrolytes and acute stroke. This study aimed to understand the difference of mean concentration of CKMB, troponin T, hemoglobin, and electrolytes and their relationship with acute stroke. This was a cross sectional study using samples of 30 subjects who were selected with consecutive non random sampling. The subjects were acquired from acute stroke patients who were proven clinically and using computed tomography (CT) scan at Haji Adam Malik General Hospital. Demographic data were analyzed using descriptive statistic. The result showed that there were no difference in demographical characteristics between the subjects. In conclusion, there were no differences in mean of CKMB, troponin T, hemoglobin, and electrolytes in acute stroke. No correlation was found between acute stroke and concentration of CKMB, troponin T, hemoglobin, and electrolytes.

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yared Zenebe Zewde ◽  
Abenet Tafesse Mengesha ◽  
Yeweynhareg Feleke Gebreyes ◽  
Halvor Naess

Abstract Background Admission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting. Methods A prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 h of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as > 140 mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively. Results A total of 103 first-ever acute stroke patients were included (mean age = 55.5 + 15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10–19) compared to normoglycemic patients 11 (IQR 8–15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99–6.19) more likely to be functionally impaired (mRS = 3–5) at 30-days compared to normoglycemic patients (P = 0.041).Older age (≥ 65 years) (P = 0.017) and stroke severity (NIHSS > 14) (P = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association. Conclusions Hyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-day of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.


2019 ◽  
Author(s):  
Yared Zenebe Zewde ◽  
Abenet Tafesse Mengesha ◽  
Yeweyenhareg Feleke Gebreyes ◽  
Halvor Naess

Abstract Background: Admission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting.Methods: A prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 hours of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as >140mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively.Results: A total of 103 first-ever acute stroke patients were included (mean age = 55.5+15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10-19) compared to normoglycemic patients 11 (IQR 8-15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99-6.19) more likely to be functionally impaired (mRS = 3-5) at 30-days compared to normoglycemic patients (p = 0.041).Older age (≥ 65 years) (p = 0.017) and stroke severity (NIHSS >14) (p = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among the patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association.Conclusions: Hyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-days of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Takahisa Mori ◽  
Kazuhiro Yoshioka ◽  
Yuhei Tanno

Abstract Background Intermittent pneumatic compression (IPC) is commonly used to prevent deep vein thrombosis (DVT) during hospitalization in patients with acute stroke. However, if DVT exists at admission, IPC of the legs with DVT may cause migration of the thrombi, resulting in pulmonary emboli. Whole-leg ultrasonography (wl-US) is a practical tool to detect DVT; however, wl-US is not always performed at admission in all stroke patients. This retrospective cross-sectional study aimed to investigate DVT frequency and identify significant factors indicating the presence of DVT at admission for acute stroke. Methods We included patients admitted within 24 h of stroke onset between 2017 and 2019. Patients who did not undergo blood tests for D-dimer or wl-US within 72 h of arrival were excluded. We collected patient data on age; sex; anthropometric variables; presence of DVT on wl-US; and biomarkers such as D-dimer, high-sensitivity C-reactive protein (hs-CRP), and lipids. Results Of 1129 acute stroke patients, 917 met our inclusion criteria. DVT was detected in 161 patients (17.6 %). Patients with DVT were older; were more likely to be female; had lower body weight; had higher D-dimer and hs-CRP levels; had lower albumin, hemoglobin, and triglyceride levels; and had higher National Institutes of Health Stroke Scale and pre-stroke modified Rankin scale scores than patients without DVT (n = 756). In addition, multiple logistic regression analysis showed that sex (female) and D-dimer levels (≥ 1.52 µg/mL) were independent significant factors for the presence of DVT. Among 161 patients with DVT, 78 (48.4 %) had both these significant factors. Among 756 patients without DVT, 602 (79.6 %) had no or one significant factor. The odds ratio of the presence of DVT in patients with both significant factors was 6.29, using patients without any significant factors as the group for comparison. Conclusions The frequency of DVT is high in acute stroke patients at admission. Female sex and a high D-dimer level were independent significant factors for the presence of DVT. Therefore, in patients with these two significant factors at admission, IPC should be avoided or wl-US should be performed before IPC.


2020 ◽  
Vol 22 (7) ◽  
Author(s):  
Pir-Hossein Kolivand ◽  
Hassanali Faraji Sabokbar ◽  
Peyman Saberian ◽  
Mahdi Bahmanabadi ◽  
Parisa Hasani-Sharamin ◽  
...  

Objectives: We intended to map the geographical distribution of patients with acute stroke who called the Tehran EMS center based on the geographic information of the incident location on a map. The distributions of these centers and patients’ access within a standard period were evaluated. Methods: A cross-sectional study based on the registered data was conducted on suspected acute stroke patients > 18 years of age that were transferred by EMS. The analysis was performed based on pointing the patients’ locations and locating the hospitals in ArcGIS software plus a review of the polygons and focal points. Results: Totally, 1,606 patients suspected to stroke with a mean age of 64.89 ± 17.48 years were evaluated, of whom 947 (58.6%) were male. The mean time of arrival of an ambulance in the patient’s location from the EMS station was 11.94 ± 6.67 minutes, and the longest time was 69.32 minutes. The mean time from the patient’s location to the stroke center was 17.79 ± 11.42 minutes (range 2.4 - 83.70 minutes). Stroke centers in Tehran are not distributed in a balanced manner, and they are concentrated on the central and northern parts of Tehran, limiting access to hospital services. Conclusions: The multiplicity of hospitals in the west and center of Tehran led to an increase in access times in eastern Tehran. It emphasizes the necessity of revision of service locating, especially because the east of Tehran has a denser texture than the west.


2013 ◽  
Vol 5 (2) ◽  
Author(s):  
Mieke A. H. N. Kembuan

Abstract: World-wide, stroke is a main public health problem. It is one of the leading causes of chronic disability and death. Both hyponatremia and hypernatremia have a negative influence on the outcome of strokes. Hyponatremia is associated with increased mortality and complication rate, meanwhile hypernatremia is often found in the treatment of cerebral oedema in strokes. There are scarce data about natrium level disorders in acute strokes, especially from developing countries. This study aimed to describe the incidence of natrium disorders among acute stroke patients, and the difference of means of natrium based on the severity of the stroke and on GCS at admission. This was a hospital-based cross-sectional study. Samples consisted of 82 patients that met the inclusion criteria. The data of natrium levels were obtained from the hospital medical records. The results showed that the incidence of natrium disorders among acute stroke victims was 30%. The mean natrium level was 138.01 Meq/L (95% CI, 135.83-140.20). The incidence of hyponatremia was 28% while hypernatremia was 2%. There was no difference of mean-natrium-levels based on the severity of strokes (P > 0.05) and of GCS (P > 0.05). Conclusion: The incidence of natrium disorders among acute stroke patients was high but there was no difference between mean natrium levels based on the severity of strokes and of GCS. Keywords: natrium, natrium level disorders, acute stroke.     Abstrak: Stroke termasuk dalam masalah kesehatan utama di masyarakat dan merupakan penyebab utama kecacatan kronik dengan angka mortalitas tertinggi ke-2 di seluruh dunia. Baik hiponatremia maupun hipernatremia memberikan pengaruh negatif terhadap keluaran stroke. Hiponatremia meningkatkan angka kematian dan komplikasi, sedangkan hipernatremia sering terdeteksi bersamaan dengan penanganan edema serebral pada stroke. Data mengenai insidens gangguan kadar natrium pada stroke akut masih sangat kurang, terutama dari negara-negara berkembang. Penelitian ini bertujuan untuk mendapatkan insidens gangguan kadar natrium pada pasien stroke akut dan deskripsi perbedaan rerata kadar natrium pada berbagai derajat defisit neurologi dan GCS saat masuk rumah sakit. Penelitian ini bersifat potong lintang berbasis rumah sakit dengan jumlah sampel sebanyak 82 dan kriteri inklusi tertentu. Hasil penelitian memperlihatkan angka insidens gangguan kadar natrium pada stroke akut sebesar 30%. Rerata kadar natrium 138.01 Meq/L (95% CI, 135,83-140,20). Hiponatremia didapatkan pada 28% kasus sedangkan hipernatremia pada 2% kasus stroke akut. Tidak terdapat perbedaan bermakna antara rerata kadar natrium berdasarkan beratnya stroke dan GCS (P > 0,05). Simpulan: Insidens gangguan kadar natrium pada stroke akut tinggi. Tidak terdapat perbedaan bermakna antara rerata kadar natrium berdasarkan beratnya stroke dan GCS. Kata kunci: natrium, gangguan kadar natrium, stroke akut.


2021 ◽  
Vol 2 (5) ◽  
pp. 01-05
Author(s):  
Mubashir Ahmed ◽  
Sohail Ahmed Siddiqui ◽  
Abdul Haq ◽  
Atif Ahmed ◽  
Pir Abdul Hayee ◽  
...  

Objective: To determine the frequency of diabetic among stroke patients and to compare the pattern of stroke in diabetic and non-diabetic stroke patients admitted at a tertiary care hospital in Hyderabad, Sindh. Methods: A cross sectional study enrolled 148 consecutive adult acute stroke patients admitted at Liaquat University Hospital, Hyderabad, during Sep 2014 to Feb 2015. Demographic, clinical, radio-imaging and laboratory data were collected on structured questionnaire to identify diabetes, type of stroke and different risk factors of stroke. Data was entered and analysed by using SPSS version 16. Association was seen by using Pearson’s Chi-square test and Independent t test. A P value of < 0.05 was considered statistically significant. Results: A total of 148 acute stroke cases were enrolled in the study. Males were 92 (62%). Mean age of study participants was 51.21 ± 10.19 years. Diabetes was found in 104 (70.3%) stroke patients. Ischemic stroke was seen in 101 (68.2%) and haemorrhagic stroke seen in 47 (31.8) stroke patients. Diabetes was more common in ischemic stroke 81 (80.2) as compared to haemorrhagic stroke 23 (48.9%) (P< 0.05). Hospital mortality of stroke patients was 37 (25%). No difference of mortality in diabetic and non-diabetic (P>0.05) stroke patients was recorded. Conclusion: Diabetes was found in majority of stroke patients. Ischemic stroke was more common than haemorrhagic stroke. Ischaemic stroke is more prevalent in diabetic whereas haemorrhagic stroke was more in non-diabetic stroke patients. Prognosis of stroke was bad in both diabetic and non-diabetic stroke patients.


2018 ◽  
Vol 23 (11) ◽  
pp. 1200-1206 ◽  
Author(s):  
Meng-Die Wang ◽  
Yong Wang ◽  
Ling Mao ◽  
Yuan-Peng Xia ◽  
Quan-Wei He ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kai Saito ◽  
Hitoshi Sugawara ◽  
Tamami Watanabe ◽  
Akira Ishii ◽  
Takahiko Fukuchi

AbstractRisk factors associated with 72-h mortality in patients with extremely high serum aspartate aminotransferase levels (AST; ≥ 3000 U/L) are unknown. This single-centre, retrospective, case-controlled, cross-sectional study obtained data from medical records of adult patients treated at Saitama Medical Center, Japan, from 2005 to 2019. We conducted a multivariate logistic after adjusting for age, sex, height, weight, body mass index, Brinkman Index, vital signs, biochemical values, updated Charlson Comorbidity Index (CCI) score, CCI components, and underlying causes. A logistic regression model with selected validity risks and higher C-statistic for predicting 72-h mortality was established. During the 15-year period, 428 patients (133 non-survivors and 295 survivors [cases and controls by survival < 72 and ≥ 72 h, respectively]) with AST levels ≥ 3000 U/L were identified. The 72-h mortality rate was 133/428 (31.1%). The model used for predicting 72-h mortality through the assessment of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus levels had a C-statistic value of 0.852 (sensitivity and specificity, 76.6%). The main independent risk factors associated with 72-h mortality among patients with AST levels ≥ 3000 U/L included higher serum values of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus.


Author(s):  
Hashim A. Mahdi ◽  
Hamza M. Assaggaf ◽  
Mohammad Alfelali ◽  
Omar B. Ahmed ◽  
Radi Alsafi ◽  
...  

This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet’s Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants’ demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18–65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors’ mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27), p = 0.02) and, visitors who had no formal education scored higher than those with post-graduate education (6.88 (±1.45) vs 5.73 (±1.12), p = 0.01). Washing hands with soap and water was the predominant method practiced after a meal (365, 91.7%), after toilet visit (354, 88.5%), after touching a surface (262, 65.7%), after waste disposal (332, 83.2%), and when hands were visibly dirty (357, 89.5%). Al Madinah visitors had moderate knowledge about hand hygiene, but demonstrated some knowledge gaps and negligence in practice that are crucial to curb the spread of COVID-19.


2021 ◽  
pp. 1-7
Author(s):  
Amélie Gabet ◽  
Clémence Grave ◽  
Edouard Chatignoux ◽  
Philippe Tuppin ◽  
Yannick Béjot ◽  
...  

<b><i>Introduction:</i></b> COVID-19 was found to be associated with an increased risk of stroke. This study aimed to compare characteristics, management, and outcomes of hospitalized stroke patients with or without a hospital diagnosis of CO­VID-19 at a nationwide scale. <b><i>Methods:</i></b> This is a cross-sectional study on all French hospitals covering the entire French population using the French national hospital discharge databases (<i>Programme de Médicalisation des Systèmes d’Information</i>, included in the <i>Système National des Données de Santé</i>). All patients hospitalized for stroke between 1 January and 14 June 2020 in France were selected. A diagnosis of COVID-19 was searched for during the index hospitalization for stroke or in a prior hospitalization that had occurred after 1 January 2020. <b><i>Results:</i></b> Among the 56,195 patients hospitalized for stroke, 800 (1.4%) had a concomitant COVID-19 diagnosis. Inhospital case-fatality rates were higher in stroke patients with COVID-19, particularly for patients with a primary diagnosis of COVID-19 (33.2%), as compared to patients hospitalized for stroke without CO­VID-19 diagnosis (14.1%). Similar findings were observed for 3-month case-fatality rates adjusted for age and sex that reached 41.7% in patients hospitalized for stroke with a concomitant primary diagnosis of COVID-19 versus 20.0% in strokes without COVID-19. <b><i>Conclusion:</i></b> Patients hospitalized for stroke with a concomitant COVID-19 diagnosis had a higher inhospital and 3 months case-fatality rates compared to patients hospitalized for stroke without a COVID-19 diagnosis. Further research is needed to better understand the excess of mortality related to these cases.


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