engleski

The prognostic value of CRP in ischemic stroke patients

Background: The early prognostic evaluation is an important step in appropriate management of ischemic stroke patients during hospitalization. Aims: The aim of the study was to evaluate prognostic value of high sensitive C-reactive protein (CRP) levels obtained on admission in clinical setting. Patients and methods: A group of 49 study subjects was recruited from patients admitted under ischemic stroke diagnosis in neurology department in our hospital. Mean age of subjects was 66±11 years, and 43% of subjects were male. Severity criteria were noted for each patient during hospitalization by using modified Rankin score (mRS). According to mRS two group were considered: group of patients without significant disability despite symptoms (GI, n=30, mRS>2) and group II, patients with moderate or severe disability (GII, n=19, mRS <2). CRP levels were determined by immunoturbidimetry from blood samples collected on admission. Obtained CRP concentrations after logarithmic transformation were compared by the one way ANOVA. Results: Significantly different CRP median levels were obtained between observed groups of patients (GI: 4.5 mg/L 95%CI (2.8-6.3) ; GII: 35.4 mg/L 95%CI (9.2-61.5), p=0.009). A ROC analysis was performed and obtained area under curve (AUC) for CRP was 0.701 with cut off 9.0 mg/L calculated from serum values. Since five patients with severe disability died during hospitalization, additional analysis was performed, between survivors and non-survivos for all patients and in GII group of patients. Obtained CRP median value in non-survivors (n=5 ; 61mg/L) were significantly higher than in survivors (n=44 ; 11.1mg/L), p=0.02. Obtained AUC for CRP was 0.705 with cut off 44.8 mg/L. Difference between median CRP values between survivors and non-survivors in GII group of patients was not significant. Conclusions: Our results support the thesis that CRP levels could be valuable parameter in ischemic stroke prognosis.

Stroke; CRP; Prognosis

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