C-Reactive Protein Levels and Clinical Outcomes in Stroke Patients: A Prospective Cohort Study.

BACKGROUND

The C-reactive protein (CRP) level, as an early prognostic factor of functional outcome after stroke, may be of clinical importance. The aim of this study was to determine the prognostic value of CRP on functional outcome and death in stroke patients.

METHODS

This prospective study was conducted from 2015 to 2016 in Hamadan province, Iran. Patients with both ischemic and hemorrhagic stroke who were admitted in the first 12 hours were enrolled. The clinical characteristics of the patients were recorded at time of admission as well as on the fourth and the 90th day after stroke. Blood sample was taken and CRP levels were measured at time of admission.

RESULTS

From 186 admitted patients, 155 patients remained in this study for analysis. Mean time between stroke onset and admission was 4.42 hours. Mean level of CRP was 20.03 mg/L. CRP levels in 68 patients (43.8%) were 7 mg/L or above. Prevalence of diabetes (P = 0.001), angina pectoris (P = 0.001), death (P = 0.001), pneumonia (P = 0.004), and DVT (P = 0.002) was significantly higher among patients with CRP levels ≥7 mg/L than patients with CRP levels <7 mg/L. A CRP level ≥7 was associated with poor clinical outcome, including the National Institutes of Health Stroke Scale (NIHSS) ≥13 (P = 0.001) as well as modified Rankin Scale (mRS) >2 (P = 0.004) and Barthel Index (BI) <70 on the first (0.047, 0.001), fourth (0.005, 0.001), and 90th day (0.001, 0.001), respectively.

CONCLUSION

Our findings indicated that elevated CRP levels in the very early phase of both ischemic and hemorrhagic stroke were associated with poor clinical outcomes and prognosis.