Akut İskemı̇k Ve Hemorajı̇k İnme Hastalarının İlk Değerlendı̇rı̇lmesı̇nde Serum C-Reaktı̇f Proteı̇n/Albumı̇n Oranı’nın Klı̇nı̇k Önemı̇

Öz

Amaç: Bu çalışmada, akut inme tanısı ile acil servise başvuran hastalarda serum C-reaktif protein/Albümin oranı (CAR), nötrofil/lenfosit oranı (NLR) ve RDW/platelet (RPR) oranının inme tipini ayırt etmedeki ve mortaliteyi öngörmedeki prediktif değerinin araştırılması amaçlanmıştır. Yöntemler: Retrospektif, kesitsel ve tek merkezli olarak yürütülen bu çalışmaya, 2 yıl içinde acil servise başvuran 846 erişkin hasta dahil edildi. Hastalar iskemik ve hemorajik inme olarak iki gruba ayrıldı. Başvuru anındaki laboratuvar bulguları üzerinden CAR, NLR ve RPR oranları hesaplandı ve NIHSS skorları ile ilişkileri değerlendirildi. Bulgular: Hastaların %96,7’si iskemik, %3,3’ü hemorajik inme grubunda yer aldı. İnme tipleri arasında CAR, NLR ve RPR açısından anlamlı fark bulunmadı (p>0,05). Mortalite oranı hemorajik inmede daha yüksekti (p=0,030). Ölen hastalarda CAR ve NLR değerleri anlamlı derecede yüksekti (p<0,05). Çok değişkenli analizde ileri yaş, yüksek NIHSS skoru ve artmış NLR mortalitenin bağımsız prediktörleri olarak saptandı. Sonuç: CAR ve NLR, inme tipini ayırt etmede yetersiz olsa da, mortalite öngörüsünde değerli biyobelirteçlerdir. Basit, erişilebilir ve düşük maliyetli bu parametreler, erken dönemde prognoz tahmininde yardımcı olabilir. Bulguların klinik uygulamaya yansıtılabilmesi için daha geniş ve farklı popülasyonlarda ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• İnme
• CRP/Albümin oranı
• Nötrofil/Lenfosit oranı
• RDW/Platelet
• Mortalite
• NIHSS

Clinical Significance of the Serum C-Reactive Protein/Albumin Ratio in the Initial Evaluation of Patients with Acute Ischemic and Hemorrhagic Stroke

Öz

Objective: This study was performed to investigate the predictive values of the serum C-reactive protein/albumin ratio (CAR), red blood cell distribution width (RDW)/platelet ratio (RPR) and neutrophil/lymphocyte ratio (NLR), in differentiating stroke subtypes and predicting mortality in patients admitted to the emergency department with a diagnosis of acute stroke. Methods: This retrospective, cross-sectional, single-center study included 846 adult patients admitted to the emergency department within a 2-year period. Patients were divided into an ischemic stroke group and a hemorrhagic stroke group. CAR, NLR, and RPR values were calculated based on laboratory findings at admission, and their associations with National Institutes of Health Stroke Scale (NIHSS) scores were evaluated. Results: Of the 846 stroke patients included in the study, 818 (96.7%) were classified as ischemic and 28 (3.3%) as hemorrhagic. There were no significant differences in CAR, NLR, or RPR values between the two stroke subtypes (p > 0.05). Mortality rates were higher in hemorrhagic stroke (p = 0.030). CAR and NLR values were significantly higher in non-survivors (p < 0.05). Multivariate analysis identified advanced age, a high NIHSS score, and a high NLR as independent predictors of mortality. Conclusion: Although CAR and NLR values are not sufficient to differentiate stroke subtypes, they serve as valuable biomarkers for predicting mortality. These simple, accessible, and cost-effective parameters may be useful in early prognostic evaluation. Further studies in larger and more diverse populations are needed to validate their clinical utility.

Anahtar Kelimeler

• stroke
• C-reactive protein/albumin ratio
• neutrophil/lymphocyte ratio
• red blood cell distribution width/platelet ratio
• mortality
• NIHSS

Kaynakça

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