Predictive value of routine hematological and biochemical parameters on 30-day fatality in acute stroke.
OBJECTIVE
This prospective study was planned to study the prognostic value of routine clinical, hematological and biochemical parameters, including platelet aggregation in patients of acute stroke, on fatality occurring during the first 30 days.


METHODS
In this study 116 consecutive patients (77 males and 39 females) of stroke (within 72 hours of onset) were included. After clinical evaluation and neuroimaging, blood investigations, hemoglobin, total leukocyte count, platelet count, platelet aggregation, erythrocyte sedimentation rate (ESR), blood sugar, urea, creatinine, sodium, potassium, serum cholesterol, serum bilirubin, aspartate aminotransferase (SGOT), alanine aminotransferase (SGPT), albumin, and globulin estimations were performed. The patients were followed up for a maximum period of 30 days from the onset of stroke, and patients who expired were grouped as 'expired' and the rest as 'survivors'. Logistic regression analysis was carried out among the significant parameters to identify independent predictors of 30-day fatality.


RESULTS
Univariate analysis demonstrated that among hematological parameters, high total leukocyte count and ESR, at admission, correlated significantly with an undesirable outcome during the initial 30 days. Among biochemical parameters, elevated urea, creatinine, serum transaminases (SGOT and SGPT) and globulin levels correlated significantly with death. Logistic regression analysis demonstrated that a low Glasgow Coma Scale (GCS) score along with biochemical parameters such as high serum creatinine, SGPT, ESR and total leukocyte count correlated with death.


CONCLUSIONS
Impaired consciousness, high total leukocyte count, raised ESR, elevated creatinine and SGPT levels, estimated within 24 hours of hospitalization, are the most important indicators of 30-day mortality in patients with first-time ischemic stroke.
Bhatia
R S
RS
Department of Neurology, King George's Medical University, Lucknow, India.
Garg
R K
RK
Gaur
S P S
SP
Kar
A M
AM
Shukla
R
R
Agarwal
A
A
Verma
R
R
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001799:Blood Sedimentation; D003404:Creatinine / Q000097:blood; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020521:Stroke / Q000097:blood* / Q000401:mortality* / Q000503:physiopathology
D003404:Creatinine; D000410:Alanine Transaminase