Document Type

Original Article


Background: Stroke severity is one of the factors that determines stroke related disability. We explored possible associations between stroke severity and commonly evaluated clinical parameters of stroke patients. Objective: To determine the relationships between clinical features including routine in- hospital investigations done in first 24 hours of admission and variations in the stroke severity. Patients and Methods: This was a retrospective, analytical study performed in the Department of Neurology at Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad, Pakistan. Adult patients admitted with ischemic stroke, over a period of 39 months, with Middle Cerebral Artery infarctions, were included. National Institute of Heath Stroke Scale (NIHSS) score was taken as a measure of stroke severity. The pertinent information was filled in a predesigned data sheet, and analyzed using SPSS version 20.0. Results: A total of 207 patients were included in the study. The highest stroke severity was found in old age ([>64 years]), and patients with cardio embolic and unclassified (> one etiology) strokes, while the lowest severity was found in small artery occlusion strokes. Higher fasting serum triglyceride levels were associated with lower stroke severity and vice versa ([P=.002]). Among supra aortic large artery atherosclerosis the pre-stroke anti-platelet ([52 %]) and beta blocker use ([53.6 %]) was significantly associated with lower stroke severity. In cardio embolic strokes active smoking was associated with increased severity ([90%]). Conclusion: Stroke severity is not only related to stroke etiology, but also, age, fasting serum triglyceride levels, active smoking and pre-stroke medications may also play significant roles. Nevertheless, further studies are required with prospective design, to confirm our findings.

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