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Abstract
Background: Stroke is one of the leading causes of
mortality and morbidity worldwide. Estimated
annual incidence of stroke in Pakistan is 250/100,000
translating to 350,000 new cases per year. The
prognosis of patient depends mainly on the severity
of the stroke. In this study we evaluated serum
calcium as a marker of severity of ischemic stroke.
Method: This cross-sectional study was conducted
at the Department of Medicine, Holy Family
Hospital, Rawalpindi, Pakistan, on 132 patients who
presented within 72 hours of acute ischaemic stroke,
from April 1 to June 30, 2017. The diagnosis of acute
ischaemic stroke was based on symptoms of focal
neurologic deficit and computed tomography (CT)
brain evidence of ischaemic infarct. Severity of
stroke was assessed using NIHSS. Patients’ serum
calcium, albumin and renal function tests were
obtained and the values along with patients’ name,
age, gender and residential address were recorded in
the study pro forma. SPSS version 22 was used for
data analysis. Pearson's correlation coefficient was
calculated to investigate the bivariate relationship
between serum calcium and stroke severity on
NIHSS.
Results: Serum calcium of all 132 patients was
measured and adjusted for serum albumin level. The
mean serum calcium was 8.74±0.58 mg/dl (range:
7.24-10.81 mg/dl). The level of calcium was below 8.7
mg/dl in 40(34.06%) patients, 8.71-9.00 mg/dl in
35(23.19%), 9.01-9.30 mg/dl in 25(22.46%) and above
9.30 mg/dl in 32(20.3%) patients. The mean NIHSS of
the respective groups was 21.56, 15.63, 18.56 and
16.25 respectively. Bivariate correlation was
calculated between continuous data of serum
calcium and NIHSS. The overall Pearson's
correlation coefficient was r = -0.318.
Conclusion: Lower serum calcium levels are
associated with greater severity of ischaemic stroke
as determined via NIHSS score.
Key Words: National institute health stroke score
(NIHSS), Ischaemic stroke, Albumin corrected serum
calcium level