engleski

Prognostic value of laboratory, clinical and neuroradiological findings in ischemic stroke outcome

Introduction/Objectives: Early outcome prediction after ischemic stroke (IS) is of great importance. Prognosis is usually based on clinical variables and neuroradiological findings, while serum biomarkers and laboratory tests may contribute to prognostic accuracy. The aim was to investigate prognostic values of laboratory, clinical and neuroradiological findings in IS outcome. Participants, Materials/Methods: We prospectively enrolled acute IS patients who presented to our hospital 24 h within an onset between September and December 2019. Initial neurological assessment was performed using the NIH Stroke Scale (NIHSS) ; patients scored ≥8 were included. Standard laboratory tests from serum (concentration of C-reactive protein, glucose, total cholesterol, low-density lipoprotein cholesterol, high- density lipoprotein cholesterol, urate, albumin and count of leucocytes) were measured at admission while prognostic nutritional index (PNI) and Glasgow prognostic score (GCS) were calculated from the values obtained. Infarct volume was calculated based on control brain CT at intervals of at least 20-24 hours after the initial one. The primary outcome was a 90-day modified Rankin score. The secondary outcome was 90-day all-cause mortality. Results: We studied 20 patients (median age 84 years, 0.65 women). All of the patients had unfavourable outcomes (mRS 3-6), and 8 (0.4) of them died. Spearman's rank correlation confirmed that 90-day mRS was positively correlated with blood glucose concentration (r=0.462, p=0.041), initial NIHSS (r=0.754, p<0.001) and infarct volume (r=0.752, p<0.001), while negative correlation was found with serum albumin concentration (r=-0.466, p=0.042) and PNI (r=-0.853, p<0.001). Mann-Whitney test showed significant differences between the groups of survivors and deceased, in PNI (p=0.01), initial NIHSS (p=0.003) and infarct volume (p=0.004). Serum concentration of C-reactive protein, total cholesterol, low- density lipoprotein cholesterol, high-density lipoprotein cholesterol, and urate, count of leucocytes and Glasgow prognostic score were not associated with outcome. Conclusions: Our findings show that higher blood glucose concentration, lower serum albumin concentration, lower PNI, higher initial NIHSS and larger infarct volume can assist the clinician in predicting unfavourable IS outcome.

stroke ; outcome

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