The Role of Laboratory Parameters in the Differentiation of Stroke Cases

Year 2024, Volume: 6 Issue: 3, 369 - 400

Busra Bıldık , Dicle Bulak , Burcu Simge Eroglu , Şeref Emre Atiş , Bora Çekmen

https://doi.org/10.37990/medr.1498380

Abstract

Aim: Globally, stroke is considered as one of the most important causes of mortality and morbidity. The most important steps for the diagnosis of stroke include rapid and focused physical examination followed by determination of the stroke’s type. The study was conducted to determine the relationship between laboratory parameters frequently requested in the emergency department and stroke type.
Material and Method: The study is a retrospective cross-sectional study. Patients’ age, gender, comorbidities, stroke type, hospitalization, in-hospital mortality and laboratory parameters were recorded and compared. p value of <0.05 was considered statistically significant.
Results: 251 patients were included in the study. The median age of the patients included in the study was 74 [64-81]. 137 (54.6%) of the patients were women. The most common comorbidity in the patients included in the study was hypertension. Ischemic stroke was seen in 236 (94%) patients and 236 (94%) were hospitalized. the platelet count in the hemorrhagic stroke and ischemic stroke group was 173 (153–204) 109/L and 218 (180–2262) 109/L, respectively. Platelet count in patients in the hemorrhagic stroke group was found to be significantly lower than in the ischemic stroke group (p=0.013). There was no significant difference in white blood cell, lymphocyte, sodium, potassium, C-reactive protein levels between both groups (p=0.318, 0.245, 0.461, 0.202, 0.322; respectively).
Conclusion: Platelet count may be used as a biomarker to differentiate between ischemic and hemorrhagic stroke in patients who are examined for stroke.

Keywords

Differentiation, hemorrhagic, ischemic, platelet, stroke

References

• Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133:e38-60.
• GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20:795-820.
• Tadi P, Lui F. Acute stroke. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535369/
• Chou C-H, Chai J-W, Wang L-C, et al. Lesion size of early cerebral infarction on a non-contrast CT influences detection ability in Cascade Mask Region-Convolutional neural networks. Biomed Signal Process Control. 2023;86:105065.
• Szypenbejl J, Siemiński M, Szurowska E, et al. CT negative subarachnoid hemorrhage in emergency department. Eur J Transl Clin Med. 2020;3:43-8.
• Xing C, Arai K, Lo EH, Hommel M. Pathophysiologic cascades in ischemic stroke. Int J Stroke. 2012;7:378-85.
• Kaplan ZS, Jackson SP. The Role of Platelets in Atherothrombosis. Hematology Am Soc Hematol Educ Program. 2011;2011:51-61.
• Kovacs S, Csiki Z, Zsori KS, et al. Characteristics of platelet count and size and diagnostic accuracyof mean platelet volume in patients with venous thromboembolism. A systematic review and meta-analysis. Platelets. 2019;30:139-47.
• Sadeghi F, Kovács S, Zsóri KS, et al. Platelet count and mean volume in acute stroke: a systematic review and meta-analysis. Platelets. 2020;31:731-9.
• Prodan CI, Vincent AS, Padmanabhan R, Dale GL. Coated-platelet levels are low in patients with spontaneous intracerebral hemorrhage. Stroke. 2009;40:2578-80.
• Du J, Wang Q, He B, et al. Association of mean platelet volume and platelet count with the development and prognosis of ischemic and hemorrhagic stroke. Int J Lab Hematol. 2016;38:233-9.
• Kakhki RD, Dehghanei M, ArefNezhad R, Motedayyen H. The predicting role of neutrophil- lymphocyte ratio in patients with acute ischemic and hemorrhagic stroke. J Stroke Cerebrovasc Dis. 2020;29:105233.
• Gökhan S, Ozhasenekler A, Mansur Durgun H, et al. Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack. Eur Rev Med Pharmacol Sci. 2013;17:653-7.
• Ekmekyapar T, Ekmekyapar M, Sahin L, et al. Clinical and radiological observation of stroke cases in the emergency department of a university hospital. Turk J Vasc Surg. 2021;10:1315-20.
• Kaya M, Kavalcı C, Öztok Tekten B. Role of haematological parameters and C-reactive protein in discrimination of ischemic and hemorrhagic stroke. Abant Med J. 2020;9:133-8.
• Zhou Y, Han W, Gong D, et al. Hs-CRP in stroke: a meta-analysis. Clin Chim Acta. 2016;453:21-7.
• Roudbary SA, Saadat F, Forghanparast K, Sohrabnejad R. Serum C-reactive protein level as a biomarker for differentiation of ischemic from hemorrhagic stroke. Acta Med Iran. 2011;49:149-52.
• Kasem AZM, Farghaly WMA, Tohamy AMA. Electrolyte disturbances in cerebrovascular stroke. Med J Cairo Univ. 2018;86:7.
• Mansoor F, Kumar J, Kaur N, et al. Frequency of electrolyte imbalance in patients presenting with acute stroke. Cureus. 2021;13:e18307.
• Setyawati YD, Mastura RR. Electrolyte disturbances and lipid profiles in ischaemic and hemorrhagic stroke patients in Aisyiyah Bojonegoro Hospital, Indonesia. Int J Res Med Sci. 2020;8:2028-32.