The effect of diger lactate and haemogram parameters on diagnosis and mortality in patients with ischaemic stroke

Introduction and Purpose: According to the World Health Organization, stroke is a clinical condition that is not due to any cause other than vascular causes, causes focal or global cerebral impairment, may last 24 hours or longer and may result in death. According to the World Health Organization, stroke is the 2nd most lethal disease after ischemic heart disease. The first goal in the treatment of acute ischemic stroke is to restore perfusion. Thus, recurrence is prevented and mortality and morbidity are reduced. Early diagnosis is very important for reperfusion in stroke. The aim of our study was to investigate whether D-dimer, lactate, WBC/MPV, PLT/LENFO, NEU/LENFO, EO, BAZ, MON, PDW, MPV values measured at admission in patients admitted to our emergency department with acute stroke have a predictive significance in early diagnosis and prediction of mortality. Material and Method: The study sample consisted of patients admitted to the Emergency Department of TOGÜ Faculty of Medicine Hospital between July 01, 2024 and March 2025 and diagnosed with ischemic stroke (100 patients) and control group patients admitted with a preliminary diagnosis of stroke between July 01, 2024 and March 2025 and imaging was obtained and ischemic stroke was excluded (100 patients). The total number of cases was 200. While obtaining the data, a descriptive analysis was created to provide information about the general characteristics of the study groups. Data on continuous variables are presented as mean±standard deviation and data on categorical variables are presented as n (%). When comparing the averages between groups in terms of quantitative variables, the Mann Whitney U test and Kruskal Wallis were used for normally distributed data and the Mann Whitney U test and Kruskal Wallis for non-normally distributed data. Cross tabulations and chi-square test were used to evaluate the presence or absence of a relationship between qualitative variables. ROC analysis was performed to evaluate D-dimer and Lactate variables on stroke. p values less than 0.05 were considered statistically significant. Available statistical software (SPSS 22.0 Chicago, IL, USA) was used for these analyses. vii Findings: Of the patients, 50% were diagnosed with ischemic stroke and 50% were normal. 55.5% were female and 44.5% were male. The mean age of the total patients was 67.02 years, 66.04 years in men and 68.24 years in women. When the patients were compared, there was a significant difference in D-dimer and lactate values (p<0.05). Conclusions: In our study, 54% of stroke patients were male and 46% were female. Hypertension was the most common risk factor among the patients diagnosed with stroke in our study. Most of the admissions due to stroke were in the fall and winter months. The most common time of admission was between 12:01 and 18:00. The most common time of admission was between 12:01 and 18:00. It was observed that the least common site of stroke was in the pons. The mortality rate among stroke-related admissions to the emergency department was 27%. When the control and patient groups were compared, the mean D-dimer value of the patient group was 1[0.5-2.04]. D-dimer value was found to be higher in stroke patients with exitus compared to healthy patients and patients with sequelae. As a result of the ROC analysis, a D-dimer value of 0.70 and above was determined as the best cut-off point and above was found to be significant for stroke risk. When the lactate values at admission were compared between the control and patient groups, the mean lactate value of the patient group was 2.01±0.95. When lactate values were analyzed at admission, it was found that lactate values were higher in stroke patients with exitus compared to healthy patients and patients with sequelae. As a result of the ROC Analysis, lactate value of 1.035 and above was determined as the best cut-off point and above was found to be significant for stroke risk. A significant difference was observed in the monocyte values of the applicants due to stroke according to gender and it was determined that the monocyte value was higher in males than females. In the leukocyte values of the applicants, the leukocyte value was found to be 11.6±6.7 in the patients with excitus and it was found to be significantly higher than the other groups. Neutrophil value at admission was found to be higher in stroke patients with exitus compared to healthy patients and patients with sequelae. MPV value at admission was found to be higher in stroke patients with sequelae compared to healthy patients. Keywords: ischemic stroke, D-dimer, lactate, hemogram parameters, comparison.