Serum Creatinine as Predictor Of Outcome in Hospitalized Patients After Acute Stroke

Mohiuddin Ahmed, R. Saha, Iftikher Alam, Muhammad Fakhrul Islam, Nur Faysal Ahmed, M. Siddique
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Abstract

Background/Aims: Acute stroke is one of the leading causes of mortality and morbidity worldwide. The adverse outcome following acute stroke depends not only on severity of the neurological defects but also on other co-morbidities. Associated renal impairment has been found to be a major predictor of different outcome following acute stroke in several studies. The aim of this study was to evaluate the impact of the serum creatinine on the outcome of hospitalized patients after acute stroke. Methods: This was a Prospective cohort study conducted on 100 consecutive adult patients who were admitted in the Neurology department of Dhaka Medical College Hospital following acute stroke during January 2018 to December 2019.The patients were followed up for two weeks after the incident stroke. Results: Among the 100 patients with acute stroke 57(57%) were ischaemic and 43(43%) were haemorrhagic stroke. Mean age(SD) was 60.4(10.6) years. Patients with ischaemic stroke were older compared to haemorrhagic stroke (61.1(9.6); 53.8(9.4) years respectively; p<0.05). The mean (SD) serum creatinine on admission in patients with both types of stroke, who deteriorated or died, were significantly higher than in those who survived. Others predictors of mortality and morbidity in both types of acute stroke were age, gender, hypertension, diabetes mellitus, ischemic heart disease, dyslipidaemia. Conclusions: Patients with impaired renal function had worse outcome after hospitalization in both types of acute stroke. Haemorrhagic stroke, older age, high baseline serum creatinine, hypertension were significantly associated with increased mortality and morbidity following acute stroke. Appropriate measures should be taken to patients with impaired renal function to reduce the mortality and morbidity following acute stroke. J Dhaka Med Coll. 2021; 29(1): 16-23
血清肌酐作为急性脑卒中住院患者预后的预测因子
背景/目的:急性脑卒中是世界范围内死亡率和发病率的主要原因之一。急性中风后的不良后果不仅取决于神经缺陷的严重程度,还取决于其他合并症。在几项研究中发现,相关肾损害是急性卒中后不同预后的主要预测因素。本研究的目的是评估血清肌酐对急性脑卒中住院患者预后的影响。方法:这是一项前瞻性队列研究,对2018年1月至2019年12月期间在达卡医学院附属医院神经内科住院的100名急性脑卒中患者进行了连续研究。这些患者在意外中风后随访了两周。结果:100例急性脑卒中中缺血性脑卒中57例(57%),出血性脑卒中43例(43%)。平均年龄(SD)为60.4(10.6)岁。缺血性卒中患者比出血性卒中患者年龄大(61.1(9.6);分别为53.8岁和9.4岁;p < 0.05)。两种类型中风患者入院时的平均(SD)血清肌酐(恶化或死亡)明显高于存活患者。两种类型急性中风的死亡率和发病率的其他预测因素是年龄、性别、高血压、糖尿病、缺血性心脏病、血脂异常。结论:两种急性脑卒中患者住院后肾功能受损的预后均较差。出血性卒中、老年、高基线血清肌酐、高血压与急性卒中后死亡率和发病率增加显著相关。对肾功能受损患者应采取适当措施,以降低急性脑卒中后的死亡率和发病率。达卡医学院,2021;(1): 29日16-23
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