STUDY OF SERUM PROCALCITONIN LEVELS IN ACUTE ISCHEMIC STROKE IN RELATION WITH ITS SEVERITY AND SHORT TERM OUTCOME

Abstract

BACKGROUND: Worldwide, stroke is a third leading cause of disability and it ranks first in frequency and importance among all the neurological disorders of adult life1. In India stroke incidence ranged from 105-152/100000 persons / year for the previous 2 decades. India also has one of the highest case fatality rate of 42 and 46 % in urban and rural population6-7. Inflammatory processes have been considered to have fundamental roles in acute ischemic stroke in both the etiology and pathophysiology16-17. It is hypothesized that quantitative rise in serum Procalcitonin is proportional to severity of acute ischemic stoke19 pointing towards greater degree of tissue damage thus poor outcome. This study aims to assess the prognostic importance of Serum Procalcitonin as a biomarker for risk stratification and prediction of functional outcome in acute ischemic stroke. OBJECTIVES: To correlate serum procalcitonin levels at the time of presentation with severity and short term outcome of acute ischemic stroke. MATERIALS AND METHODS: It is a prospective observational study involving 68 patients who presented within 24 hours of onset of acute ischemic stroke. Blood sample of 2mL was taken and sent for serum procalcitonin levels and severity was calculated using NIHSS and short term outcome was calculated at 4th day using Barthel index. xii RESULTS: In our study mean age of subjects being 62.28 ± 12.303 years with predominant males(61.8%). It was observed that PCT was high among the patients who had more severe stroke as seen by NIHSS(p= <0.001) at the time of presentation. i.e more the NIHSS higher the level of PCT. Higher level of PCT was inversely proportional to Barthel index(p= 0.001) on day 4. Hence PCT at higher level at presentation signifies poor short term outcome. CONCLUSION: Serum PCT is a good predictor of severity at the time of presentation and poor functional outcome at day 4 of acute ischemic stroke.