Evaluation of Laboratory Parameters in Stroke Patients Based on Decompressive Craniectomy Timing

Abstract

Background: Decompressive craniectomy reduces mortality and morbidity in ischemic stroke patients with malignant cerebral edema. Prognostic markers such as red cell distribution width, neutrophil lymphocyte ratio, and platelet count are needed to predict the timing of decompressive surgery in ischemic stroke patients. Sodium, a parameter that changes before and after decompression surgery, may also be a factor to consider when assessing the patient's prognosis and deciding whether to proceed with surgery. In this study, we aimed to examine the changes in laboratory parameters in stroke patients according to the time of decompression surgery. Material and Method: At our stroke center, 52 patients were diagnosed with stroke and underwent decompressive craniectomy. The patients were divided into four groups based on their decompression time (the first 24 hours, 24-48 hours, 48-72 hours, and after 72 hours). The width of the red cell distribution, platelet count, neutrophillymphocyte ratios, and sodium levels were calculated and compared between groups and National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores are all listed. Results: The patients had a mean age of 62 ± 11 years, with 31 males and 21 females. The patients' admission, 24th hour, and post-operative sodium levels were not significantly different. The patients' admission, 24th hour, and post-op RDW did not differ statistically significantly. The 24th hour NLR levels of the groups differed significantly (p=0.049). Conclusion: There is a need for laboratory measurements that can estimate the time required for decompression surgery. Nevertheless, no significant difference between groups was observed in our study, which investigated at RDW, NLR, platelet count, and sodium levels.