Predictors of outcome after acute ischemic stroke among Egyptians

Abstract

Background: Stroke has a high health burden, which make it among the disabilities leading disorders, especially among middle- income and high-income countries. Various factors can affect ischemic stroke prognosis, such as age group, initial stroke severity, stroke subtype, infarction site, comorbid diseases, and associated complications.

Objectives:  To study the potential predictors of outcome after acute ischemic stroke among Egyptians.

Patients and Methods: One hundred first-ever AIS patients without any pre-morbid handicap who were recruited. They were subjected to MRI brain with diffusion weighted image volume infarct size assessment, stroke scales and scores and laboratory investigations.

Results: Forty-one patients had high level of high sensitive CRP and IL-6, 59 with low levels of insulin, 51 with dyslipidemia as they had high levels of LDL-C and only 2 patients with high level of homocysteine. Elevated total cholesterol level, lowered HDL level and high level of LDL had statistical significant correlation with the stroke outcome. Reduction of HDL, high level of total cholesterol, higher NIHSS at admission and larger DWI volume more than 55.8 cm3 were the significant independent predictors of outcome.

Conclusion:  Initial ischemic stroke severity at time of presentation defined by higher NIHSS scores, higher levels of cholesterols with low HDL levels and larger diffusion weighted image volume of infarction are associated with poor outcome after acute ischemic stroke in Egyptians.