Iskemik inme ile acil servise başvuran hastalarda akut faz reaktanlari ve sitokin düzeyleri ile kisa dönem mortalite arasindaki ilişki

The association between acute phase reactant, cytokine levels and short term mortality in patients with ischemic stroke admitted to emergency departmentPurpose: We aimed to study the association between acute phase reactant, cytokine levels, Glasgow Coma Scale (GCS), National Institution Health Stroke Scala (NIHSS) and short term mortality in patients with ischemic stroke admitted to emergency department. We also want to evaluate the markers which could be a predictor of diagnosis and treatment of ischemic stroke.Methods: This study was projected to investigate the association between descriptive and short term mortality in forwards. The protocol of this study was approved by the Ethics Committee School of Medicine, Cukurova University. Study population was designed in patients admitted to Department of Emergency, Cukurova University, School of Medicine and diagnosed as ischemic stroke in the date between 13.02.2007 and 31.12.2008. A questionnaire was applied to the all subjects in order to interview about age, gender, the date of admission to emergency department, the way of admission to emergency department, the time period before the of admission to emergency department, history of his health, GCS, NIHSS, brain tomography, laboratory report, patients admission and outcome time from neurology intensive care unit, outcome type of the patient, ischemic area dimensions on the brain tomography. These questionnaires were documented clearly during the study. Seventy five patients diagnosed as ischemic stroke were included in the study. Statistics were carried out using the SPSS 17 statistical packet program.Results: Seventy five patients ? 36 female (48%) and 39 male (52%) ? were included in the study. The age of patients was 66.8±15.8 ? female; 70.4±11 and male; 63±12.9 ? (p=0.005). Five female (13.9%) and five male (12.8%) patients died. There was not any statistically significant between discharged and died patients in both female and male patients (p=0,999). The duration of hospital stay of death and living patients was 5.9±4.1 and 12.2±5.7, respectively (p=0.001). GCS of died and living patients were 9.6±1.6 and 13.5±2.1, respectively when they first admitted (p<0.001). NIHSS of died and living patients were 22.4±6.7 and 8.8±6.4, respectively when they first admitted (p<0.001). CRP levels of died and living patients were 39.2±45.9 and 20±32.6 respectively when they first admitted (p=0.029). There was not any statistically significant in other acute phase reactant and cytokines.Conclusion: We established that there is a positive correlation between CRP and prognosis in patient with ischemic stroke included in this study. We also established that direct association between lesion volume and prognosis. It was demonstrated GCS and NIHSS are the best markers in evaluating prognosis of the functional state of patient with ischemic stroke in daily practice. Further studies are needed to assess the association between ischemic stroke and acute phase reactant.Keywords: Ischemic stroke, acute phase reactants, GCS, NIHSS.