Morbidity predictors in ischemic stroke.
BACKGROUND
Although ischemic CVA is one of the leading causes for death and disability, parameters for predicting long-term outcome in such patients have not been clearly delineated, especially in the Indian context.


METHODS
A prospective hospital-based study of 105 patients of ischemic stroke, focal neurological deficits and functional score was assessed and the C-reactive protein level (CRP) was measured. A follow-up was done at 5 days and at 6 months and outcome variable was the functional status at 6 months using Barthel Index of Activities of Daily Living. Accordingly, patients were grouped into 3 - Barthel Index < 41: Severely disabled, Barthel Index 41-60: Moderately disabled and Barthel Index > 60: Mildly disabled.


RESULTS
At admission, if upper limb power was less than Medical Research Council (MRC) grade 4, or aphasia was present or CRP assay was positive, then at 6 months, these patients most likely belonged to the severely disabled group. If upper limb or lower limb power was greater than MRC grade 3 or there was no aphasia or conjugate gaze deviation or CRP assay was negative, these patients most likely belonged to the mildly disabled group at 6 months. Follow-up rate was 86%.


CONCLUSIONS
Patients can be stratified according to the predicted prognosis. The treatment and rehabilitation can be properly planned and strictly adhered to in patients predicted to have worse prognosis.
Panicker
J N
JN
Department of Hematology, Medical College, Thiruvananthapuram, Kerala, India. tatsat@vsnl.com
Thomas
M
M
Pavithran
K
K
Nair
D
D
Sarma
P S
PS
D000203:Activities of Daily Living; D002545:Brain Ischemia / Q000175:diagnosis* / Q000401:mortality*; D004185:Disability Evaluation; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality*