SERUM ALBUMIN LEVELS AND ITS CORRELATION WITH SHORT TERM OUTCOME IN ACUTE ISCHEMIC STROKE PATIENTS

2021 ◽  
pp. 12-13
Author(s):  
Avtar Singh Dhanju ◽  
Thiyagu K ◽  
Ajay Chhabra ◽  
Pashaura Singh
Keyword(s):  
Ischemic Stroke ◽  
Serum Albumin ◽  
Acute Ischemic Stroke ◽  
Albumin Level ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Short Term ◽  
Term Outcome ◽  
Nihss Score ◽  
The Relationship

Aim:The study was undertaken with the aim to establish the denite correlation between serum albumin levels and outcome of ischemic stroke. Methodology: The present observational study was conducted on 100 acute ischemic stroke patients meeting inclusion and exclusion criteria. All patients were investigated for hypoalbuminemia and their stroke severity was assessed by NIHSS score on day 1 and day 7. The relationship between admission albumin levels, NIHSS values and outcome of those patients was ascertained. Results: There was increased prevalence of hypoalbuminemia in AIS patients and there was signicant correlation between NIHSS score on day 1&7, mortality and hypoalbuminemia in AIS patients and there was signicant association between high NIHSS score and mortality in AIS patients. Conclusion: serum albumin is an independent predictor of functional outcome following an acute ischemic stroke and serum albumin level is inversely correlated with severity of stroke at presentation.

scholarly journals Frequency of Hypoalbuminemia in Acute Ischemic Stroke patients Based on Stroke Severity

2021 ◽  
Vol 15 (6) ◽  
pp. 1335-1339
Author(s):  
E. U Haq ◽  
A. Qayyum ◽  
H. A. Qayyum ◽  
M. Anam ◽  
A. R. Khan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Serum Albumin ◽  
Acute Ischemic Stroke ◽  
Public Health Issue ◽  
P Value ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Baseline Serum ◽  
Nihss Score ◽  
The Mean

Background: Stroke is a serious public health issue and third leading cause of death worldwide. Hypoalbuminemia is commonly found factor in patients of stroke and is also associated with severe disease as well as pro inflammatory patterns of serum protein electrophoresis. Therefore, further research for understanding the role of Hypoalbuminemia in stroke is important to devise strategies for better management of stroke. Aim : To determine the frequency of hypoalbuminemia in acute ischemic stroke patients based on stroke severity. Methods: This descriptive cross- sectional study was conducted in Shifa International hospital stroke unit for 6 months from May 15, 2018 till Nov 15, 2018. Data was collected from 100 patients using purposive sampling. After taking consent from patient or attendant, the demographic data was collected on a structured proforma. Baseline serum albumin and stroke severity using the NIHSS score was also assessed. All data was entered and analysed using SPSS 21. After descriptive analysis, post stratified Chi Square test was applied for gender and age categories. Results: The mean age of patients was 63.60 ± 11.87 years with 57(57%) male and 43(43%) female cases. The mean serum albumin level was 4.03 ± 0.94 with minimum and maximum values as 1.50 and 5.5. Among cases with minor, moderately severe and with severe stroke, 6(37.5%) cases, 18(25.7%) cases and 6(42.9%) cases had Hypoalbuminemia. The frequency of hypoalbuminemia was statistically same with respect to severity of stroke, p-value > 0.05. Conclusion: This study concludes that the frequency of hypoalbuminemia in acute ischemic stroke patients was diagnosed in almost one third cases, however, no statistical association could be found. Hence, screening for hypoalbuminemia should be done for better management of stroke patients. Keywords: Storke, NIHSS score, serum albumin, hypoalbuminemia, mortality

Correlation of Serum Albumin Level with Short Term Outcome of Acute Ischemic Stroke Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Saad El-Din Mahmud ◽  
Hala Mahmoud EL-Khawas ◽  
Hossam El Din Mahmoud Afify ◽  
Mohamed Mohamed Tawfik
Keyword(s):  
Ischemic Stroke ◽  
Serum Albumin ◽  
Acute Ischemic Stroke ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Short Term ◽  
The Mean ◽  
Discharge From Hospital

Abstract Objectives We aimed to Detect if there is association between serum albumin level in acute ischemic stroke patients and its short term neurological and functional outcome in a tertiary care hospital in Cairo. Methods The study was carried out as descriptive (cross-sectional) study conducted on 50 cases first-ever acute ischemic stroke patients were enrolled between June 2018 to December 2018 with follow up after 30 days of discharge from hospital. Inclusion and exclusion criteria were strictly exercised. National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) score was noted. Serum albumin (SA) was estimated from blood Clinical, functional, and radiological evaluation was done for the patients. Statistical SPSS 20.0 software and Microsoft excel were used for statistical analysis (P ≤ 0.05).Relationship between serum albumin and stroke outcome was determined. Results A total of 50 stroke cases were thus included in the study comprising 34 males and 16 females. The mean age of patients was 40-65 [59.26±6.25] years, we found the most prevalent risk factors in the present study results were hypertension 36 (72.0%). The mean serum level of albumin were (3.73±0.63) on day o of onset and (3.72±0.63) after 30 days of discharge from hospital. Bivariate analysis shows serum albumin was inversely associated with NIHS score and mRS on day o of onset and after 30 days of discharge from hospital which were NIHSS(r= -0.264, P = 0.044) (r= -0.645, P = <0.001) and mrs (r= -0.321, P = 0.031) (r= -0.587, P = <0.001) respectively. Conclusion Hypoalbuminemia had influence to degree of stroke severity, degree of disability and functional outcome. Serum albumin levels had a negatively correlation with NIHSS score and modified Rankin scale. Low serum albumin levels associated with poor prognosis in acute ischemic stroke patients.

scholarly journals Role of some inflammatory biomarkers in prediction of short-term outcome in acute ischemic stroke

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Yosria Abd Al Hameed AlTaweel ◽  
Rania Sanad Nageeb ◽  
Pakinam Mahmoud Metwally ◽  
Ahmed Elsayed Badawy
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Severity ◽  
Short Term ◽  
Laboratory Assessment ◽  
Term Outcome ◽  
Neutrophil Lymphocyte Ratio ◽  
Short Term Outcome ◽  
Wbc Count

Abstract Background Several factors affect acute ischemic stroke (AIS) outcomes. Objective This study aimed to assess the role of the leukocyte count, neutrophil/lymphocyte ratio (NLR), and c reactive protein (CRP) as early predictors of outcome in AIS patients. Methods This study was conducted on 60 AIS patients. They were subjected to detailed history taking, clinical examination, brain imaging, and laboratory assessment including the CRP, white blood cell (WBC) count, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and NLR which is calculated by dividing ANC by ALC. Neurological scales were used to assess the level of consciousness by the Glasgow Coma Scale (GCS) and stroke severity by the National Institute of Health Stroke Scale (NIHSS) at the first 48 h of stroke onset as well as 1 week and 2 weeks later for the assessment of short-term functional neurological outcome. Results Sixty percent of the patients had unfavorable outcomes assessed by the Modified Rankin Scale (mRS). Patients with unfavorable outcomes had higher NIHSS scores. NLR was positively correlated with WBC count, ANC, and CRP. The higher WBC, NLR, and NIHSS, the unfavorable the outcome was. Conclusion The higher WBC, the NLR, and the level of CRP at the onset of AIS, the more severe stroke and the poorer the short-term outcome are expected.

Prevention of Venous Thromboembolism after Acute Ischemic Stroke with Enoxaparin Versus Unfractionated Heparin and the Impact of Stroke Severity.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 713-713 ◽  
Author(s):  
David G. Sherman ◽  
Gregory W. Albers ◽  
Christopher Bladin ◽  
Min Chen ◽  
Cesare Fieschi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Venous Thromboembolism ◽  
Acute Ischemic Stroke ◽  
Stroke Severity ◽  
Primary Efficacy ◽  
Primary Efficacy Endpoint ◽  
Stroke Patients ◽  
Nihss Score ◽  
Vte Prophylaxis ◽  
Clinically Significant

Abstract Background: Venous thromboembolism (VTE) prophylaxis with low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) is recommended in acute ischemic stroke patients, but most studies comparing LMWH and UFH are limited in methodology or sample size. The PREVAIL study was designed to assess the superiority of enoxaparin over UFH for VTE prophylaxis in acute ischemic stroke patients and to evaluate efficacy and safety according to stroke severity. Methods: Patients with acute ischemic stroke, confirmed by CT scan, and unable to walk unassisted due to motor impairment of the leg were enrolled in this prospective, open-label, parallel group, multicenter study. Patients from 15 countries were randomized within 48 h of stroke symptoms to receive enoxaparin 40 mg SC qd or UFH 5000 IU SC q12h for 10±4 days. Patients were stratified by NIH Stroke Scale score (NIHSS; severe ≥14, less severe <14). The primary efficacy endpoint was the composite of symptomatic or asymptomatic deep-vein thrombosis (DVT), symptomatic pulmonary embolism (PE), or fatal PE during treatment. DVT was confirmed primarily by venography, or ultrasonography when venography was not practical. PE was confirmed by VQ or CT scan, or angiography. Primary safety endpoints included clinically significant intracranial and major extracranial bleeding. Results: 1762 acute ischemic stroke patients were randomized. Characteristics were similar between groups; mean age was 66.0±12.9 yrs, mean NIHSS score was 11.3. In the efficacy population, enoxaparin (n=666) and UFH (n=669) were given for a mean of 10.5±3.2 days. Enoxaparin resulted in a 43% relative reduction in the risk of the primary efficacy endpoint compared with UFH (10.2% vs 18.1%; RR 0.57; 95% CI 0.44–0.76; p=0.0001, adjusted for NIHSS score). Incidences of VTE events are shown in Table 1. Reductions in the primary endpoint remained significant in patients with a NIHSS score ≥14 (16.3% vs 29.7%, p=0.0036) and <14 (8.3% vs 14.0%, p=0.0043). The composite of clinically significant intracranial and major extracranial bleeding was low and not significantly different between groups (Table 1). Conclusion: Enoxaparin 40 mg qd is superior to UFH q12h for reducing the risk of VTE in acute ischemic stroke patients, with no significant difference in clinically relevant bleeding. The reduction in VTE risk was consistent in patients with a NIHSS score ≥14 or <14. Table 1: Incidence of VTE and bleeding Endpoint Enoxaparin n/N (%, 95% CI) UFH n/N (%, 95% CI) *P<0.001 Symptomatic VTE 2/666 (0.3, 0.0–0.7) 6/669 (0.9, 0.2–1.6) Proximal DVT 30/666 (4.5, 2.9–6.1) 64/669 (9.6, 7.3–11.8)* Distal DVT 44/666 (6.6, 4.7–8.5) 85/669 (12.7, 10.2–15.2)* PE 1/666 (0.2, 0.0–0.4) 6/669 (0.9, 0.2–1.6) Composite of major extracranial and clinically significant intracranial bleeding 11/877 (1.3, 0.5–1.9) 6/872 (0.7, 0.1–1.2)

scholarly journals Neurobiochemical Markers of Brain Damage in Cerebrospinal Fluid of Acute Ischemic Stroke Patients

2010 ◽  
Vol 56 (3) ◽  
pp. 451-458 ◽  
Author(s):  
Raf Brouns ◽  
Bart De Vil ◽  
Patrick Cras ◽  
Didier De Surgeloose ◽  
Peter Mariën ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Calcium Binding ◽  
Infarct Volume ◽  
Neuron Specific Enolase ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Nihss Score

Abstract Background: Ischemic injury to the central nervous system causes cellular activation and disintegration, leading to release of cell-type–specific proteins into the cerebrospinal fluid (CSF). We investigated CSF concentrations of myelin basic protein (MBP), glial fibrillary astrocytic protein (GFAP), the calcium-binding protein S100B, and neuron-specific enolase (NSE) in acute ischemic stroke patients and their relation to initial stroke severity, stroke location, and long-term stroke outcome. Methods: CSF concentrations of MBP, GFAP, S100B, and NSE were assessed in 89 stroke patients on admission (mean 8.7 h after stroke onset) and in 35 controls. We evaluated the relation between CSF concentrations and (a) stroke severity (NIH Stroke Scale [NIHSS] score on admission, infarct volume), (b) stroke location, and (c) stroke outcome (modified Rankin Scale [mRS] score at month 3). Results: MBP concentration was significantly higher in subcortical than in cortical infarcts (median MBP, 1.18 vs 0.66 μg/L, P < 0.001). GFAP and S100B concentrations correlated with the NIHSS score on admission (GFAP, R = 0.35, P = 0.001; S100B, R = 0.29, P = 0.006), infarct volume (GFAP, R = 0.34, P = 0.001; S100B, R = 0.28, P = 0.008), and mRS score at month 3 (R = 0.42, P < 0.001 and R = 0.28, P = 0.007). Concentrations of NSE did not correlate with stroke characteristics. Conclusions: MBP, GFAP, S100B, and NSE display relevant differences in cellular and subcellular origins, which are reflected in their relation to stroke characteristics. MBP is a marker for infarct location. GFAP and S100B correlate with stroke severity and outcome.

scholarly journals Association of Serum Bilirubin with Stroke Severity and Clinical Outcomes

2013 ◽  
Vol 40 (1) ◽  
pp. 80-84 ◽  
Author(s):  
Tian Xu ◽  
Jintao Zhang ◽  
Tan Xu ◽  
Wenqing Liu ◽  
Yan Kong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Outcomes ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Direct Bilirubin ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Short Term ◽  
Fourth Quartile

Objective:The aim of the study is to explore the association of serum bilirubin levels with admission severity and short term clinical outcomes among acute ischemic stroke patients.Methods:Data were collected from 2361 acute ischemic stroke patients in four hospitals of Shangdong Province during January 2006 and December 2008. National Institutes of Health Stroke Scale (NIHSS) was used to assess admission and discharge severity. NIHSS≥10 at discharge or in-hospital death was defined as short-term clinical outcomes. Logistic regression and trend test were used to examine the association of serum bilirubin levels with admission severity and short term clinical outcomes.Results:Serum bilirubin levels were significantly and positively associated with admission severity (P for trend <0.05). The age-sex adjusted odds ratios (95% confidential intervals) of NIHSS≥10 associated with the second, third and fourth quartile of total bilirubin/direct bilirubin were 1.245 (0.873, 1.777)/1.276 (0.895, 1.818), 1.484 (1.048, 2.102)/1.628 (1.158, 2.289) and 2.869 (2.076, 3.966)/2.765 (1.996, 3.828), respectively, compared with the lowest quartile; the multivariate adjusted odds ratios of NIHSS≥10 associated with the second, third and fourth quartile of total bilirubin/direct bilirubin were 1.088(0.711, 1.665)/1.436(0.94, 2.193), 1.328(0.877, 2.011)/1.647(1.092, 2.485) and 2.336(1.579, 3.458)/3.079 (2.049, 4.623), respectively, compared with the lowest quartile. However, no association between serum bilirubin levels and short-term clinical outcomes was observed in our study.Conclusion:Serum bilirubin levels were associated with initial stroke severity closely. Nevertheless, there is no significant relationship between serum bilirubin levels and short-term clinical outcomes among acute ischemic stroke patients.

scholarly journals Neutrophil to lymphocyte ratio, stroke severity and short term clinical outcomes in acute ischemic stroke

2021 ◽  
Vol 26 (3) ◽  
pp. 479-484
Author(s):  
Ilkin Iyigundogdu ◽  
Eda Derle ◽  
Seda Kibaroglu ◽  
Ufuk Can
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neutrophil To Lymphocyte Ratio ◽  
University Hospital ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Potential Indicator

Background: Neutrophil to lymphocyte ratio is an easily evaluated systemic inflammation indicator. However, there are limited reports on neutrophil to lymphocyte ratio and functional outcome in ischemic stroke. In this study, we aimed to evaluate the association of neutrophil to lymphocyte ratio and stroke severity, short term functional outcomes and mortality in patients with acute ischemic stroke. Methods: The clinical data of patients who were > 18 age-old and hospitalized with acute ischemic stroke in Baskent University Hospital, Ankara, Turkey between January 2018 and May 2019 were studied retrospectively. Neutrophil to lymphocyte ratio were measured. The neutrophil to lymphocyte ratio and National Institute of Health Stroke Scale (NIHSS) score at admission, mortality during hospitalization and Modified Rankin Scale (mRS) score at discharge of the patients with acute ischemic stroke were correlated. Results: Among the acute ischemic stroke patients due to the exclusion criteria, the data of 134 patients were evaluated. Median age of the patients were 76± 12.5 years and 82 patients (61.2%) were male. The median NIHSS scores of the patients at admission was 5±4.5. Mortality during the hospitalization was seen in 8 patients (6%). The median neutrophil to lymphocyte ratio value of the patients at admission were found to be 2.6±3.4. Neutrophil to lymphocyte ratio and NIHSS scores of the patients at admission, duration of the hospitalization, mRS scores at discharge and mortality during hospitalization were found to be positively correlated. Conclusion: Neutrophil to lymphocyte ratio is a simple and easily measured marker and can be used as a potential indicator for prognosis in acute ischemic stroke. However further prospective multicenter investigations are required to confirm the role of neutrophil to lymphocyte ratio for predicting the prognosis in acute ischemic stroke patients.

Abstract T MP86: A Prospective Study of the Effect of Dehydration on Stroke Severity and Short Term Outcome

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Mona N Bahouth ◽  
Argye Hillis ◽  
Rebecca Gottesman
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Urine Specific Gravity ◽  
Stroke Severity ◽  
Lesion Volume ◽  
Stroke Patients ◽  
Short Term ◽  
Term Outcome ◽  
Comprehensive Stroke Center ◽  
Stroke Center

Background: Many ischemic stroke patients present to the hospital in a state of dehydration. We hypothesized that patients who were dehydrated at the time of acute stroke would have more severe stroke and worse short term outcomes. Methods: We enrolled consecutive ischemic stroke patients within 12 hours from their last normal neurological exam at a single academic health system. Patients with renal failure or who were unable to undergo MRI were excluded. Surrogate markers for dehydration were defined as BUN/Creatinine ratio >15 and urine specific gravity >1.010. Stroke severity was determined based on clinical examination (NIHSS score) and lesion volume measured on diffusion weighted MRI. The primary outcome of interest was change in NIHSS from admission to discharge. Results: We surveyed 383 ischemic stroke admissions to our comprehensive stroke center. Of these, 168 met inclusion criteria with 126/168 (75%) having complete laboratory and MRI data. 44% of our patients were dehydrated at the time of admission, with no difference in demographics between the dehydrated and hydrated groups. Baseline NIHSS (6.7 vs 7.3; p=0.63) and lesion volumes (12 vs 16; p=0.48) were similar in the two groups. 42% of dehydrated patients were in the worst short term quartile of NIHSS change, as compared with 17% of the hydrated group (p=0.02). Dehydration remained a significant predictor of having the worst NIHSS change, after adjustment for age, initial NIHSS, lesion volume, and admission glucose (OR=4.34, 95% CI 1.75-10.76). Conclusions: Nearly half of acute stroke patients admitted to the hospital are dehydrated by surrogate laboratory markers. Acute stroke patients with markers of dehydration demonstrate greater worsening in NIHSS scores as compared with hydrated patients, independent of infarct size. Results suggest an opportunity for an inexpensive and globally available treatment to optimize functional outcomes of the stroke patient.

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