Microalbuminuria as a predictor of an early neurological deterioration in acute ischemic stroke.

Abstract

Background: Stroke is a major cause of long-term disability among patients. Early Neurological Deterioration (END) has serious consequences on the short term (morbidity and death) and long term (recovery from stroke) outcomes in patients with acute ischemic stroke (AIS). Studies have shown a higher prevalence of microalbuminuria in those patients with AIS (1). This study was done to evaluate microalbuminuria as a predictor of END in acute ischemic stroke. Methods: An observational prospective study was conducted among AIS patients who presented to the department of General medicine, R L Jalappa Hospital (RLJH) from march 2018 to august 2019. 73 patients with first episode of acute ischemic stroke presenting within first 24 hours after onset of symptoms were enrolled in the study. The neurological status and the severity of stroke were assessed by applying the NIHSS (National Institute of Health Stroke Scale) score on day 1 and day 3 on all patients. END was diagnosed if there was an increase in the NIHSS score by 3 or more from day 1 to day 3 of admission. Presence of microalbuminuria in patients were assessed by calculating UACR at presentation. Microalbuminuria was then correlated with END in these patients. Results: Microalbuminuria was present in 80% of patients whereas in group without END, 18.86% had microalbuminuria.(p < 0.001). The presence of microalbuminuria was significantly more among patients who developed END. It was also found that patients with severe stroke (75%) were more in the group with END compared to those without (37.73%) with p value of <0.001, which was statistically significant. Conclusion: Results of our study suggests that presence of microalbuminuria can predict development of early neurologic deterioration in acute ischemic stroke patients and hence to be treated aggressively.