Fibrinogen as a Predictor of Early Neurological Deterioration in Acute Ischemic Stroke – Evidence From the Indian Population.

Background: Early neurological deterioration (END) is a common occurrence in ischemic stroke and contributes significantly to poor outcomes. Although multiple factors that predict END have already been identified, the role of fibrinogen – a key component of the coagulation pathway, is controversial....

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Publicado en:Journal of Central Nervous System Disease pp. 1 - 9
Autores principales: Mehta, Vishal, Sharma, Akhya, Jyoti, Divya, Prabhakar, Rathod, Kumar, Ritesh, Guria, Rishi T., Sharma, Chandra B.
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 2/7/2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2/7/2023
      pid: 344
      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.1177/11795735231156349
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        atl: Fibrinogen as a Predictor of Early Neurological Deterioration in Acute Ischemic Stroke – Evidence From the Indian Population.
      aug:
        au:
          Mehta, Vishal
          Sharma, Akhya
          Jyoti, Divya
          Prabhakar, Rathod
          Kumar, Ritesh
          Guria, Rishi T.
          Sharma, Chandra B.
        affil: Department of Medicine, 78602 Rajendra Institute of Medical Sciences, Ranchi, India
      sug:
        subj:
          Fibrinogen Adverse Effects
          Clinical Deterioration
          Nervous System Diseases India
          Ischemic Stroke
          Outcomes (Health Care) Evaluation
          Prediction Models
          Human
          Odds Ratio
          Confidence Intervals
          India
          Prospective Studies
          Nonexperimental Studies
          Scales
          Blood Glucose
          Early Diagnosis
      ab: Background: Early neurological deterioration (END) is a common occurrence in ischemic stroke and contributes significantly to poor outcomes. Although multiple factors that predict END have already been identified, the role of fibrinogen – a key component of the coagulation pathway, is controversial. Objective: To assess the role of fibrinogen in predicting END and poor hospital outcome in patients with acute ischemic stroke. Design: Single-centre prospective observational study. Methods: 141 patients with acute ischemic stroke were analyzed in this prospective observational study from a single tertiary-care hospital in East India. END was defined as a worsening of ≥2 points on the National Institutes of Health Stroke Scale (NIHSS) within 7 days of admission. A score of 3-5 on the Modified Rankin Scale (mRS), a stroke recurrence event or death during hospital stay was considered poor hospital outcome. We performed univariate analysis using age, sex, body-mass index (BMI), hypertension, diabetes, NIHSS scores, stroke etiology, blood glucose and lipid parameters and plasma fibrinogen to develop a logistic regression model to establish the independent predictors of END and poor outcome. Results: Age (Odds Ratio (OR) 1.034 [95% CI 1.001-1.069], P =.046), NIHSS score at admission (OR 1.152 [95% CI 1.070-1.240], P <.001) and fibrinogen (OR 1.011 [95%CI 1.006-1.015], P <.001) were independent predictors of END in patients with acute ischemic stroke. Factors independently associated with poor outcome were NIHSS score at admission (OR 1.257 [95% CI 1.150-1.357], P <.001), fasting plasma glucose (OR 1.007 [95% CI 1.001-1.013], P =.020), and fibrinogen [OR 1.004 [95% CI 1.000-1.007], P =.038). Conclusion: The significant role of fibrinogen in determining neurological worsening and subsequent poor outcomes in patients with acute ischemic stroke may help in early prognostication and guided therapeutic interventions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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