Study of Correlation of Serum Albumin Levels and in-Hospital Outcome in Acute Ischemic Stroke Subjects

Background: Acute ischemic stroke (AIS) is defined by the sudden loss of blood flow to an area of the brain with the resulting loss of neurologic function. Stroke is the second most common cause of death and disability-adjusted life years worldwide. Albumin is mainly synthesized in the liver and classified as a non-glycosylated plasma protein and is involved in the transport of small molecules, is used as a co-factor in different essential pathways, and contributes as a major force in limiting fluid leakage from vascular compartment into the interstitium, also offers neuroprotective effect. This study is undertaken to study the correlation between Serum Albumin Levels and In-Hospital Outcome in Acute Ischemic Stroke Subjects. Method: Longitudinal observational study was done for a period of 1 year in KR Hospital, Mysore in 30 acute ischemic stroke patients who met inclusion and exclusion criteria. After taking institutional ethical clearance the nature of study was explained to patient and patient party and written informed consent taken. Clinical and demographic profile at the time of admission were recorded and laboratory investigations (CBC, LFT, RFT, S/E, RBS, Lipid profile, NCCT Head, ECG, 2D Echo) were performed within 24 hours of admission. Neurological status at the time of admission were assessed using NIHSS and were classified into 4 categories (Minor, Moderate, Moderate-severe, Severe). Functional outcome was assessed on day 7 of admission using mRS (modified Rankin scale) and were divided into 2 categories (Poor outcome, Non poor outcome). The outcomes were correlated with serum albumin level. Result: In the present study, Out of the 30 subjects, 60% were males and 40% were females. Majority of the patients belonged in 41-60 years age group (53.3%). Hypertension was the most common risk factor observed in the study (70%). Most of the cases were in NIHSS Moderate-severe category (33.3%). Serum albumin levels at the time of admission were shown to have inverse correlation with severity at admission and outcome at day 7. Conclusion: The findings in present study suggest that there is an inverse correlation between serum albumin and outcome in patients with acute ischemic stroke. It also shows that low admission levels of serum albumin correlates with high NIHS scores indicating severity of stroke. Serum Albumin level can be used as cost effective marker for prognostication in acute ischemic stroke patients.