Dr. Mythili K, K Baburaj and Dr. Paari N
Acute Ischemic Stroke (AIS) is a leading cause of disability, morbidity and mortality saddling the overburdened Global Health System. LV dysfunction is a well established risk factor for AIS, however its significance as a prognostic marker for in-hospital morbidity after AIS was hardly ever studied.
Aim: To evaluate the Left Ventricular function and determine its correlation with the severity of neurological impairment. To appraise whether LV dysfunction is a prognostic marker for in-hospital morbidity.
Materials & Methods: Between November 2019 and October 2021, a prospective study was conducted at Rajah Muthiah Medical College and Hospital. 75 study participants with AIS were enrolled and clustered into two groups on the basis of NIHSS. Study population with NIHSS < 6 were designated as Group-1 and those with NIHSS ≥ 6 as Group-2. Left ventricular function was assessed using routine 2D Echocardiography. In addition, the two inflammatory biomarkers, Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) were computed from Complete Blood Count (CBC).
Results: The study showed that the patients in Group-2 had higher values of NLR and PLR but lower LVEF than those in Group-1. The threshold values of NLR, PLR and LVEF obtained from the ROC curve were 4.1, 195 and 64% respectively. The values of NLR & PLR greater than 4.1 & 195 along with LVEF <64% were associated with severe neurological impairment and higher in-hospital morbidity.
Conclusion: NLR and PLR have a significant positive correlation with NIHSS, whereas LVEF has significant negative association with NIHSS. Hence, NLR, PLR and LVEF, subsequent to AIS, can be used as a prognostic marker for in-hospital morbidity.
