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. 2023 Feb 7:15:11795735231156349.
doi: 10.1177/11795735231156349. eCollection 2023.

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

Vishal Mehta  1 , Akhya Sharma  2 , Divya Jyoti  1 , Rathod Prabhakar  1 , Ritesh Kumar  1 , Rishi T Guria  1 , Chandra B Sharma  1
Affiliations

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

Vishal Mehta et al. J Cent Nerv Syst Dis. .

Abstract

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.

Keywords: acute ischemic stroke; early neurological deterioration; fibrinogen; national institutes of health stroke scale; outcome.

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Conflict of interest statement

AS: Conceptualization, Methodology, Supervision, Validation, Visualization, Writing – reviewing and editing. DJ: Data curation, Formal analysis, Investigation, Resources, Software, Validation, Visualization. RP: Data curation, Formal analysis, Investigation, Validation, Writing – reviewing and editing. RK: Investigation, Methodology, Validation, Writing – reviewing and editing. RTG: Conceptualization, Supervision. CBS: Conceptualization, Supervision The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of the study.
See this image and copyright information in PMC

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