Investigation of the relationship between inflammatory markers and grade of disease in patients with acute ischemic stroke with partial anterior circulation infarct

Abstract

Objectives: The aim of this study was to investigate the relationship between National Institutes of Health Stroke Scale scores and Glasgow coma scores of patients with partial anterior ischemic stroke and laboratory results, particularly serum CRP, albumin, platelet and other complete blood count data, and prognosis. Methods: In this retrospective study 226 of patients with partial anterior circulation infarction who were admitted to the Bolu Abant İzzet Baysal University Neurology Clinic between January 2021 and 2022 with the diagnosis of acute ischemic stroke and hospitalized within the first 24 hours were investigated. The demographic data, stroke etiology and risk factors, National Institutes of Health Stroke Scale, Glasgow coma scores, complete blood count, certain inflammatory markers and biochemical parameters, length of hospital stay and mortality rates were examined. And the relationship between inflammatory markers and grade of disease was evaluated statistically. Results: The patients with moderate Glasgow coma score had a lower lymphocyte level, severe patients had higher PCT level and moderate patients had higher CRP level among others. Patients with moderate GCS had higher CRP/ALB val­ues than those with mild. Patients with moderate and moderate-severe National Institutes of Health Stroke Scale had higher RBC and HGB levels than the patients with mild. Moderate-severe patients had lower albumin lev­els. Conclusion: CRP-albumin ratio, serum platelet and serum albumin levels may have prognostic value in acute partial anterior ischemic stroke patients.

Keywords

• albumin
• CRP-albumin ratio
• HDL-uric acid ratio
• stroke

References

1. Güven HH, Çilliler AE, Sarikaya SA, Köker C, Çomoğlu SS. The etiologic and prognostic importance of high leukocyte and neutrophil counts in acute ischemic stroke. Journal of Neurological Sciences (Turkish) 2010;27:311–8.
2. Guven H, Çilliler AE, Koker C, Sarikaya SA, Comoglu SS. Association of serum calcium levels with clinical severity of acute ischemic stroke. Acta Neurol Belg 2011;111:45–9.
3. Dehghan A, van Hoek M, Sijbrands EJ, Hofman A, Witteman JCM. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care 2008;31:361–2.
4. Guerreiro S, Ponceau A, Toulorge D, Martin E, Alvarez-Fischer D, Hirsch EC, Michel PP. Protection of midbrain dopaminergic neurons by the end-product of purine metabolism uric acid: potentiation by low-level depolarization. J Neurochem 2009;109:1118–28.
5. Thijs LG, Hack CE. Time course of cytokine levels in sepsis. Intensiv Care Med 1995;21 Suppl 2:S258–63.
6. Artero A, Zaragoza R, Camarena JJ, Sancho S, Gonzalez R, Nogueira JM. Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock. J Crit Care 2010;25:276–81.
7. Goldwasser P, Feldman J. Association of serum albumin and mortality risk. J Clin Epidemiol 1997;50:693–703.
8. Demirel ME. The correlation of c-reactive protein/albumin, Mii-1 and Mii-2 indexes with hospitalization and mortality in Stanford type A aortic dissection. Medical Records 2022;4:361–6.

9. Demirel ME. Acute coronary syndromes and diagnostic methods. Medical Research and Innovations 2019;3:1–8.
10. Mert I, Cetinkaya A, Gurler M, Turel CA, Celik H, Torun IE, Turel I. Anti-inflammatory potential of liraglutide, a glucagon-like peptide-1 receptor agonist, in rats with peripheral acute inflammation. Inflammopharmacology 2022;30:1–13.
11. Kocatürk M, Kocatürk Ö. Assessment of relationship between C-reactive protein to albumin ratio and 90-day mortality in patients with acute ischaemic stroke. Neurol Neurochir Pol 2019;53:205–11.
12. Rocco A, Ringleb PA, Grittner U, Nolte CH, Schneider A, Nagel S. Follow-up C-reactive protein level is more strongly associated with outcome in stroke patients than admission levels. Neurol Sci 2015; 36:2235–41.
13. Yang M, Pan Y, Li z, Yan H, Zhao X, Liu L, Meng X, Wang Y, Wang Y. Platelet count predicts adverse clinical outcomes after ischemic stroke or TIA: subgroup analysis of CNSR II. Frontiers in Neurology 2019;10:370.