The role of radiologic,clinical and biochemical parameters in prediction of stroke mortality

Objectives:To assess National Institutes of Health Stroke Scale (NIHSS), stroke volume, biochemical, and blood parameters for the prediction of one-month mortality in stroke patientsMethods:The study had retrospective design and 75 patients were involved that presented to a hospital Emergency Department between January 2016 and December 2017 in Adiyaman, Turkey diagnosed with acute ischemic cerebral infarction. The patients were divided into 2 groups according to whether mortality occurred within one month. Values for NIHSS, stroke volume, Glasgow Coma Scale, and blood parameters were compared between the groups.Results:Values for Glasgow Coma Scale p=0.002, NIHSS p=0.001, stroke volume p=0.003, monocyte/HDL ratio p=0.047, neutrophils p=0.01, white blood cell p=0.007, calcium p=0.016, and albumin p=0.027 were statistically significant for the prediction of one-month mortality. There were no significant differences between the groups for other parameters.Conclusion:The clinical, laboratory, and radiological findings individually provide significant support for the short-term prognosis of stroke. The evaluation of these results together can provide a clearer advance understanding of a prognosis to better manage the course of the disease and prevent death.

Stroke is the third most common cause of death for patients presenting to emergency departments worldwide.1 Thus, to foresee possible mortality and morbidity in stroke cases, adoption of the right treatment and follow-up approach is important.2 The quality of the health service in a hospital emergency department depends on the successful prediction of the course of the disease and the clinical picture that may arise. Being aware of the prognosis of the disease in advance is important not only for making optimal treatment decisions but also for correctly informing the patient and managing health expenditures.In the literature, clinical parameters such as C reactive protein (CRP), red cell distribution width (RDW), neutrophil/lymphocyte ratio, and routine blood parameters such as albumin, infarct volume on admission, and National Institutes of Health Stroke Scale (NIHSS) score have previously been defined for the prediction of mortality in stroke cases.2-5 Pro-brain natriuretic peptides and pro-atrial natriuretic peptides, 2 other biochemical parameters that are not among the routine blood parameters, have also been shown to be important markers of stroke prognosis.6,7This study aimed to evaluate the association of clinical, biochemical, and radiological parameters with one-month mortality in patients that presented to the emergency service and received a diagnosis of ischemic stroke.