title: Plasma gelsolin levels and 1-year mortality after first-ever ischemic stroke.
abstract: OBJECTIVE
  Plasma gelsolin depletion has been associated with poor outcome of critically ill patients. We sought to investigate change in plasma gelsolin level after ischemic stroke and to evaluate its relation with disease outcome.
  
  
  METHODS
  Fifty healthy controls and 172 patients with first-ever ischemic stroke were included. Plasma samples were obtained within 24 hours from stroke onset. Its concentration was measured by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Plasma gelsolin level in stroke patients was significantly decreased compared with healthy controls. A multivariate analysis showed that plasma gelsolin level was an independent predictor for 1-year mortality (odds ratio, 0.945; 95% confidence interval [CI], 0.918-0.974; P = .0002) and negatively associated with National Institutes of Health Stroke Scale (NIHSS) score (t = -4.802, P < .001) and plasma C-reactive protein level (t = -4.197, P < .001). A receiver operating characteristic curve identified that a baseline plasma gelsolin level less than 52.0 mg/L predicted 1-year mortality of patients with 73.0% sensitivity and 65.2% specificity (area under curve [AUC], 0.738; 95% CI, 0.666-0.802). The predictive value of the gelsolin concentration was similar to that of NIHSS score (AUC, 0.742; 95% CI, 0.670-0.806; P = .940). Gelsolin improved the AUC of NIHSS score to 0.814 (95% CI, 0.747-0.869; P = .032).
  
  
  CONCLUSIONS
  Plasma gelsolin level is a useful, complementary tool to predict mortality after ischemic stroke.
authors.affiliation: Department of Laboratory Medicine, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, PR China. gxcdxq@163.com
authors.forename: Xi-Chao
authors.initials: XC
authors.lastname: Guo
authors.forename: Ben-Yan
authors.initials: BY
authors.lastname: Luo
authors.forename: Xue-Fen
authors.initials: XF
authors.lastname: Li
authors.forename: Da-Gan
authors.initials: DG
authors.lastname: Yang
authors.forename: Xu-Nin
authors.initials: XN
authors.lastname: Zheng
authors.forename: Kan
authors.initials: K
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002545:Brain Ischemia / Q000097:blood / Q000401:mortality; D016022:Case-Control Studies; D002681:China; D003422:Critical Care; D005260:Female; D018260:Gelsolin / Q000097:blood*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000401:mortality*; D016019:Survival Analysis
chemical_list: D018260:Gelsolin