A Study on the Role of Serum Calcium, Serum Albumin and Serum Uric Acid as Markers of Initial Neurological Severity and Short Term Outcome Indicators in Acute Ischemic Stroke.

UNLABELLED

Stroke is defined as 'the rapid development of clinical signs and symptoms of a focal neurological deficit lasting for more than 24 hours or leading to death with no apparent cause other than vascular origin'. Serum Calcium has an important role in signal transduction pathways and may influence the severity of stroke during initial period. Serum Albumin as an acute phase reactant; with its neuro-protective action prejudices the recovery. Whereas Serum Uric acid acts as a marker of tissue infarction; indicating poor prognosis of ischemic stroke. This study was conducted using these three lab parameters to assess the severity & short term prognosis of acute ischemic stroke.

MATERIAL

This is a one year Observational Cross sectional study conducted on 65 patients aged above 18 years, presenting with Acute Ischemic Stroke within 24 hours of onset. Patients with Haemorrhagic stroke, chronic liver & renal diseases were excluded. National Institute of Health Stroke Scale (NIHSS) severity score was calculated at admission, with estimation of Serum Calcium, Albumin & Uric acid. Short term prognosis is assessed based on functional improvement using Modified Rankin Scale (MRS) grading done at the end of 1st week.

OBSERVATION

Stroke was common in the age group of 5th to 8th decade. Male & female patients were 45 (69.23%) and 20 (30.77%) respectively. Male preponderance was seen with the ratio of 2.25:1. Hypertension was seen in 17 patients (26.15%), overlapping comorbidities were observed in 19 patients (29.23%), Diabetes in 06 patients (9.23%), Coronary artery disease in 05 (7.69%). Hypertension and Diabetes did not show any significant correlation on outcome. Lab parameters like serum calcium, serum albumin and serum uric acid when compared with NIHSS scoring; the positive correlation was seen only with low serum calcium levels and the other two parameters did not show any positive correlation. Similarly comparing all the three parameters with Modified Rankin Scale did not show any positive correlation.

CONCLUSION

We observed a significant correlation only between serum calcium levels and NIHSS severity. The three lab parameters did not yield any association with MRS grades. There is a need to conduct a large scale prospective study and to consider various other patient related factors to eliminate bias and to establish association between those three lab parameters with acute ischemic stroke.