Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke: The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood Biomarkers
Avan Sabir Rashid,1,2 Yumin Huang-Link,1,2 Marcus Johnsson,1,2 Simon Wetterhäll,1,2 Helena Gauffin1,2 1Department of Biomedical and Clinical Sciences (BKV), Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; 2Department of Neurology, Linköping University Hospital, Regi...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-09-01
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| Series: | Neuropsychiatric Disease and Treatment |
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| Online Access: | https://www.dovepress.com/predictors-of-early-neurological-deterioration-and-functional-outcome--peer-reviewed-fulltext-article-NDT |
| _version_ | 1818482310700335104 |
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| author | Sabir Rashid A Huang-Link Y Johnsson M Wetterhäll S Gauffin H |
| author_facet | Sabir Rashid A Huang-Link Y Johnsson M Wetterhäll S Gauffin H |
| author_sort | Sabir Rashid A |
| collection | DOAJ |
| description | Avan Sabir Rashid,1,2 Yumin Huang-Link,1,2 Marcus Johnsson,1,2 Simon Wetterhäll,1,2 Helena Gauffin1,2 1Department of Biomedical and Clinical Sciences (BKV), Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; 2Department of Neurology, Linköping University Hospital, Region Östergötland, Linköping, SwedenCorrespondence: Helena Gauffin, Department of Neurology, University Hospital, Linköping, 581 85, Sweden, Tel +46705762044, Fax +46101034141, Email Helena.gauffin@regionostergotland.seBackground: Early neurological deterioration (END) in acute ischemic stroke (AIS) can be associated with poor outcome. The aim of this study was to investigate the association between infarction subtypes, biomarkers and END, and to identify patients with risk of unfavorable functional outcome.Materials and Methods: This prospective study enrolled 101 patients with AIS. Neurological status was evaluated according to NIHSS at acute onset, on days 2, 3, and 90. END was defined as ≥ 2-point increase of NIHSS within 72 hours. Functional outcome was assessed using NIHSS and the modified Rankin Scale (mRS) at day 90.Results: END was observed in 20, 8%. Patients with large artery disease had higher risk of developing END compared with patients with cardioembolism or small vessel disease (p < 0.01). Significant higher blood glucose level and leukocytes were observed in the END group. Patients with END had higher scores of mRS at day 90 (p < 0.01). Levels of NSE, IL-6, hsCRP and NT-proBNP were higher in the patients with unfavorable compared with favorable functional outcome.Conclusion: Large artery disease, high blood glucose and leukocytes levels are associated with END. Elevated levels of blood markers NSE, IL-6, HsCRP and NT-proBNP indicate poor functional outcome at 90 days after AIS. These patients must be identified and be offered treatment immediately in order to improve the functional outcome after AIS.Keywords: acute ischemic stroke, early neurological deterioration, large artery disease, blood biomarkers, functional outcome |
| first_indexed | 2024-12-10T11:46:03Z |
| format | Article |
| id | doaj.art-2ceabefe6c1d425abcaadf6953e12add |
| institution | Directory Open Access Journal |
| issn | 1178-2021 |
| language | English |
| last_indexed | 2024-12-10T11:46:03Z |
| publishDate | 2022-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Neuropsychiatric Disease and Treatment |
| spelling | doaj.art-2ceabefe6c1d425abcaadf6953e12add2022-12-22T01:50:04ZengDove Medical PressNeuropsychiatric Disease and Treatment1178-20212022-09-01Volume 181993200278008Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke: The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood BiomarkersSabir Rashid AHuang-Link YJohnsson MWetterhäll SGauffin HAvan Sabir Rashid,1,2 Yumin Huang-Link,1,2 Marcus Johnsson,1,2 Simon Wetterhäll,1,2 Helena Gauffin1,2 1Department of Biomedical and Clinical Sciences (BKV), Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; 2Department of Neurology, Linköping University Hospital, Region Östergötland, Linköping, SwedenCorrespondence: Helena Gauffin, Department of Neurology, University Hospital, Linköping, 581 85, Sweden, Tel +46705762044, Fax +46101034141, Email Helena.gauffin@regionostergotland.seBackground: Early neurological deterioration (END) in acute ischemic stroke (AIS) can be associated with poor outcome. The aim of this study was to investigate the association between infarction subtypes, biomarkers and END, and to identify patients with risk of unfavorable functional outcome.Materials and Methods: This prospective study enrolled 101 patients with AIS. Neurological status was evaluated according to NIHSS at acute onset, on days 2, 3, and 90. END was defined as ≥ 2-point increase of NIHSS within 72 hours. Functional outcome was assessed using NIHSS and the modified Rankin Scale (mRS) at day 90.Results: END was observed in 20, 8%. Patients with large artery disease had higher risk of developing END compared with patients with cardioembolism or small vessel disease (p < 0.01). Significant higher blood glucose level and leukocytes were observed in the END group. Patients with END had higher scores of mRS at day 90 (p < 0.01). Levels of NSE, IL-6, hsCRP and NT-proBNP were higher in the patients with unfavorable compared with favorable functional outcome.Conclusion: Large artery disease, high blood glucose and leukocytes levels are associated with END. Elevated levels of blood markers NSE, IL-6, HsCRP and NT-proBNP indicate poor functional outcome at 90 days after AIS. These patients must be identified and be offered treatment immediately in order to improve the functional outcome after AIS.Keywords: acute ischemic stroke, early neurological deterioration, large artery disease, blood biomarkers, functional outcomehttps://www.dovepress.com/predictors-of-early-neurological-deterioration-and-functional-outcome--peer-reviewed-fulltext-article-NDTacute ischemic strokeearly neurological deteriorationlarge artery diseaseblood biomarkersfunctional outcome |
| spellingShingle | Sabir Rashid A Huang-Link Y Johnsson M Wetterhäll S Gauffin H Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke: The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood Biomarkers Neuropsychiatric Disease and Treatment acute ischemic stroke early neurological deterioration large artery disease blood biomarkers functional outcome |
| title | Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke: The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood Biomarkers |
| title_full | Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke: The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood Biomarkers |
| title_fullStr | Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke: The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood Biomarkers |
| title_full_unstemmed | Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke: The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood Biomarkers |
| title_short | Predictors of Early Neurological Deterioration and Functional Outcome in Acute Ischemic Stroke: The Importance of Large Artery Disease, Hyperglycemia and Inflammatory Blood Biomarkers |
| title_sort | predictors of early neurological deterioration and functional outcome in acute ischemic stroke the importance of large artery disease hyperglycemia and inflammatory blood biomarkers |
| topic | acute ischemic stroke early neurological deterioration large artery disease blood biomarkers functional outcome |
| url | https://www.dovepress.com/predictors-of-early-neurological-deterioration-and-functional-outcome--peer-reviewed-fulltext-article-NDT |
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