Renal Dysfunction Is an Independent Risk Factor for Poor Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis: A New Cutoff Value.

Objective. This study was set to assess the effect of renal dysfunction on outcome of stroke patients treated with intravenous thrombolysis (IVT). Methods. This multicenter research involved 403 patients from January 2009 to March 2015. Patients were divided into two groups: (1) control group with GFR ≥ 45 mL/min/1.73 m2 and (2) low GFR group with GFR < 45 mL/min/1.73 m2. Outcome measurements were poor outcome (mRS 3-6) and mortality at 3 months and symptomatic intracerebral hemorrhage (SICH) within the first 24-36 hours. Univariate and multivariate regression analyses were performed, and odds ratios (ORs) were determined at 95% confidence intervals (CIs). Results. Univariate analyses determined that every decrease of GFR by 10 mL/min/1.73 m2 significantly increased the risk of poor outcome (OR 1.19, 95% CI 1.09-1.30, p < 0.001) and mortality (OR 1.18, 95% CI 1.06-1.32, p = 0.002). In multivariate regression, adjusted for all variables with p value < 0.1, low GFR (GFR < 45 versus GFR equal to or more than 45) was associated with poor outcome (OR adjusted 2.15, 95% CI 1.01-4.56, p = 0.045). Conclusion. In IVT for acute stroke, renal dysfunction with GFR < 45 mL/min/1.73 m2 before treatment determined increased odds for poor outcome compared to GFR of more than 45 mL/min/1.73 m2.

Evaluating role of leukocytosis and high sedimentation rate as prognostic factors in acute ischemic cerebral strokes.

Leukocytosis and increased Erythrocyte Sedimentation Rate (ESR) during the early phases of acute ischemic stroke has been proposed to be related with poor prognosis. The aim of this study was to evaluate these two parameters in patients with ischemic stroke. In this descriptive analytical study, 150 patients with confirmed ischemic stroke were taken under study for a period of 13 month. The White Blood Cell (WBC) count and ESR were determined on admitting and after 3 days. Any history of Diabetes Mellitus (DM), Hypertension (HTN), Heart Disease (HD), Hyperlipidemia (HLP), smoking, CT scan findings, level of consciousness and the condition of patient on admission and discharge (according to Rankin's scale) were assessed. In this study, 150 patients were enrolled, in which 75 were males and 75 were females, with the mean age of 67.3 +/- 8.2 years. Leukocytosis on day one was significantly more prevalent in patients passed away during hospitalization or discharged in not-so-well condition. High WBC and ESR levels, altered consciousness, diffused lesions in CT scan and imperfect neurological condition on day one, as well as positive history of DM and HTN were significantly related with higher in-hospital death rate and/or poor condition at discharge. Raised WBC count and ESR just after an ischemic stroke attack might be related with a poor prognosis and necessitate immediate and meticulous monitoring and therapies.