NOVEL INFLAMMATORY MARKERS AND THEIR ASSOCIATIONS WITH FUNCTIONAL OUTCOME IN ACUTE ISCHEMIC STROKE
1 Resident in Department of Neurology, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada / RSUP Dr. Sardjito, Yogyakarta, Indonesia
2 Staff in Department of Neurology, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada / RSUP Dr. Sardjito, Yogyakarta, Indonesia
3 Staff in Department of Neurology, RS Pusat Angkatan Udara dr. S. Hardjolukito, Yogyakarta, Indonesia
Monocyte-to-HDL ratio (MHR) and C-Reactive Protein (CRP)-to-albumin ratio (CAR) are two emerging novel inflammatory markers that are currently widely studied in many patients, particularly in critically ill conditions. However, the study to identify the clinical usefulness of these markers in patients with acute ischemic stroke is lacking.
MATERIAL and METHOD:
It was a pilot study using cross-sectional method in acute ischemic stroke patients in Dr. Sardjito Hospital, Yogyakarta. The subjects were consecutively recruited upon their admission to Stroke Unit between the time range of September to November 2020. All clinical and laboratory parameters used in this study were derived from initial examinations. The patients were divided into independent vs dependent groups according to the initial Barthel Index (BI) score, with the cut-off point of 85. Bivariate statistical analyses were performed using Fisher exact test, t-test and Mann-Whitney, according to the data distribution.
Of the 27 patients, there were 14 patients (51.85%) in dependent group. The baseline characteristics of these patients were comparable, except for the significantly higher NIHSS score in dependent group showing the more severe clinical presentation of stroke (median value 3 vs 6, p<0.05). MHR did not show any significant difference, but CAR showed to be significantly higher in dependent group (median value 0.758 vs 1.842, p<0.05) suggesting the increased inflammation processes. Furthermore, the overall infection complications, including urinary tract infection, pneumonia, and decubitus ulcer, in this group were significantly increased.
Increased CAR may be associated with more severe clinical presentation and poorer functional outcome on patient’s admission as well as the risk of infection complication. Further study with larger subjects and cohort methods are necessary to reveal the usefulness of these markers in clinical setting of stroke.