Predictors of Mortality and Morbidity in Acute Ischemic Stroke

Objectives: Stroke, despite improvements in treatment is still a serious cause of mortality and morbidity. The most important prognostic factors of stroke are known as the neurological condition of the patient in first hours, the size of the lesion that imaging revealed, and the age. In this study, prognostic indicators such as erythrocyte sedimentation rate (ESR), folate, vitamin B12 (vit B12), mean corpuscular volume (MCV), white blood cell (WBC) count, hematocrit, glucose were investigated to help determining the course of the treatment. Method: In this retrospective study 272 ischemic stroke patients admitted to our emergency department and neurology clinic within the first 24 hours were included. Early laboratory findings were recorded. The patients were categorized into two groups as good and poor prognosis, based on their modified rankin scores at the time of hospital discharge. Patients’ ages, laboratory results, length of the hospitalization, and medical histories were compared. Results: Hypertension was found to be the highest ranked stroke risk factor among the patients. Statistically significant difference was detected on age, MCV, folic acid, WBC, and ESR between groups with good and poor prognosis. Logistic regression analysis revealed that advanced age, high MCV and low folate are associated with poor prognosis.Discussion: Advanced age is the most important predictor of poor outcome. High MCV and low folate levels are also contribute to the mortality and morbidity rates. Both parameters are related to hyperhomocysteinemia, which is one of the risk factors of stroke. Therefore, prospective studies investigating the effect of homocysteine, folic acid, vit B12, MCV on the prognosis of stroke are required. (Arc-hi-ves of Neu-ropsy-chi-atry 2013; 50: 40-44)