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The related main theme: A. Stroke and Cerebral vascular disorders

CORRELATION BETWEEN HYPOALBUMINEMIA AT ADMISSION AND POOR FUNCTIONAL OUTCOME OF ISCHEMIC STROKE PATIENTS IN RSUP DR SARDJITO

Authers:

Clara Valencia   Okkywulandari, MD 1 , Abdul  Gofir, MD 2 , Ahmad  Asmedi, MD 2 , Tommy Rachmat  Setyawan, MD 2 , Siti Farida  Setyaningrum, MD 2 , 
1 Resident at Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
2 Staff at Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Corresponding Author:

Clara Valencia   Okkywulandari

keywords: acute ischemic stroke hypoalbuminemia functional
Abstract for original article

OBJECTIVES /BACKGROUND:
Serum albumin has an important role, as it binds strongly to fatty acids and various metabolites that bind various free anions and cations, and exerts neuroprotective effects, especially in acute ischemic stroke. Albumin levels decrease in response to acute inflammation, in which hypoalbuminemia will worsen the functional outcome of acute ischemic stroke patients. The purpose of this study was to determine the correlation between hypoalbuminemia on admission and poor functional outcome in acute ischemic stroke patients.

MATERIAL and METHOD:
A cross-sectional descriptive analytic study, with the subject being inpatients at the Stroke Unit of Sardjito Hospital between January and September of 2020. Inclusion criteria were the first incidence of acute ischemic stroke and serum albumin levels were measured within 24 hours of hospital admission. Hypoalbuminemia was defined as below 3.5 g/dL. Subjects were assessed for their functional status after the 5th day of onset with the modified Rankin Scale (mRS) with the cutoff of >2 for unfavorable outcome. The relationship between variables was tested using the Chi-square test. The results were considered statistically significant if the p value was <0.05.

RESULT:
There were 77 subjects included, with hypoalbuminemia in 21 subjects (27.3%) and the mean albumin of 3.88 mg/dl. Based on the mRS score, 56 subjects (72.7%) had unfavorable functional outcome. There is a significant association between hypoalbuminemia and unfavorable functional outcome of mRS (p = 0.007, OR =11.1, 95 % CI = 1.38 – 89.06)

DISCUSSION:
Hypoalbuminemia increased the risk of getting a poor functional outcome in acute ischemic stroke patients. The results of this study are consistent with previous studies which concluded that a lower serum albumin in acute ischemic stroke patients was associated with poor functional outcomes assessed by the modified Rankin Scale (mRS). Functional outcomes using mRS should be continued with assessment until at least 6 months after onset.


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