BMJ open · 2024
Can high-sensitivity C reactive protein (hsCRP) be used as a prognostic marker of functional disability after acute ischaemic stroke? A cross-sectional study at a tertiary care centre in Eastern India.
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Vamshikrishnapatel Kotha, Biswas Ratnadeep, Kumar Vijay, Ojha Vishnu Shankar
Аннотация
OBJECTIVES: This study was conducted with the aim of assessing the correlation between highly sensitive C reactive protein (hsCRP) levels and indicators of disability and functional impairment in individuals presenting with acute ischaemic stroke (AIS).
DESIGN: Cross-sectional study.
SETTING: Department of General Medicine at the All India Institute of Medical Sciences, Patna, Eastern India from August 2022 to August 2023.
PARTICIPANTS: The study population comprised a total of 125 patients aged 18 years or more, presenting within 48 hours of symptom onset or time last known well and having confirmed ischaemic stroke through CT or MRI of the brain. Individuals with a history of prior stroke, other neurological disorders, active infections, known coronary artery disease, chronic kidney disease, chronic liver disease and abnormal blood cell counts were excluded.
PRIMARY OUTCOME MEASURES: Modified Rankin scale (mRS) and Barthel Index (BI) scores on day 2 and day 5 were the primary outcome measures.
RESULTS: The hsCRP levels on day 2 and day 5 were significantly positively correlated with the National Institutes of Health Stroke Scale scores with Spearman's rho 0.303 (p=0.001) and 0.386 (p<0.001), respectively. The hsCRP on day 2 exhibited a significant association with mRS scores (p=0.04), indicating disability, but this significance was not sustained on day 5 (p=0.125). A negative correlation was observed between hsCRP and BI scores on both day 2 (Spearman's rho=-0.265, p=0.003) and day 5 (Spearman's rho=-0.297, p=0.002). While the hsCRP levels on day 2 did not differ significantly between fatal and non-fatal cases (p=0.110), the hsCRP levels on day 5 were significantly higher in fatal cases (p<0.001).
CONCLUSIONS: This study underscores the potential utility of hsCRP as a prognostic indicator in patients with AIS. Elevated hsCRP levels correlated with increased stroke severity and functional disability. Regular assessments of hsCRP in the early phase of AIS could contribute to predicting prognosis and guiding optimal patient management.
DESIGN: Cross-sectional study.
SETTING: Department of General Medicine at the All India Institute of Medical Sciences, Patna, Eastern India from August 2022 to August 2023.
PARTICIPANTS: The study population comprised a total of 125 patients aged 18 years or more, presenting within 48 hours of symptom onset or time last known well and having confirmed ischaemic stroke through CT or MRI of the brain. Individuals with a history of prior stroke, other neurological disorders, active infections, known coronary artery disease, chronic kidney disease, chronic liver disease and abnormal blood cell counts were excluded.
PRIMARY OUTCOME MEASURES: Modified Rankin scale (mRS) and Barthel Index (BI) scores on day 2 and day 5 were the primary outcome measures.
RESULTS: The hsCRP levels on day 2 and day 5 were significantly positively correlated with the National Institutes of Health Stroke Scale scores with Spearman's rho 0.303 (p=0.001) and 0.386 (p<0.001), respectively. The hsCRP on day 2 exhibited a significant association with mRS scores (p=0.04), indicating disability, but this significance was not sustained on day 5 (p=0.125). A negative correlation was observed between hsCRP and BI scores on both day 2 (Spearman's rho=-0.265, p=0.003) and day 5 (Spearman's rho=-0.297, p=0.002). While the hsCRP levels on day 2 did not differ significantly between fatal and non-fatal cases (p=0.110), the hsCRP levels on day 5 were significantly higher in fatal cases (p<0.001).
CONCLUSIONS: This study underscores the potential utility of hsCRP as a prognostic indicator in patients with AIS. Elevated hsCRP levels correlated with increased stroke severity and functional disability. Regular assessments of hsCRP in the early phase of AIS could contribute to predicting prognosis and guiding optimal patient management.