| Abstrakt: |
Background: Stroke, world's second-most common cause of morbidity, is a devastating illness in itself. When complicated metabolic issues, the outcomes in stroke begin to significantly differ. One such important metabolic derangement is electrolyte imbalance, an important coexisting finding seen in stroke patients. Our study focusses on serum electrolyte levels in acute stroke, and their correlation with stroke severity as well as clinical outcomes in acute stroke patients. Materials and Methods: The present study was a hospital based prospective observational study and was carried out on 110 patients presenting with symptoms of Acute Stroke from March 2021-July 2022. The patients were followed up for a period of 3 months after getting discharged from the hospital; lost to follow up were contacted telephonically. Serum electrolyte levels were measured at the time of admission. Estimation of Severity of stroke was done using National Institute of Health Stroke Scale (NIHSS) and Clinical outcome of the study was analysed according to data collected. Results: Hemorrhagic stroke was seen 31.8% and ischemic stroke was seen in 68.2%. 15 subjects (13.6%) showed hyponatremia while 34 subjects (30.9%) had hypernatremia and the remaining 61 subjects (58.5%) had normal sodium levels. Hypernatremia was more common in hemorrhagic stroke (37%) than in ischemic stroke (28%). 29 subjects (26.4%) showed hypokalaemia while 7 subjects (6.4%) had hyperkalaemia and the remaining 74 subjects (67.2%) had normal potassium levels. Hypokalemia was more common in hemorrhagic stroke (42.9%) than ischemic stroke (18.7%). 4 subjects (3.6%) showed hypochloraemia while 38 subjects (34.6%) had hyperchloremia and the remaining 68 subjects (61.8%) had normal chloride levels. Hyperchloremia was seen in both ischemic (25 subjects out of 75, 33.3%) and hemorrhagic stroke (13 subjects out of 35, 37.1%). Electrolyte imbalances overall were found to be unrelated to stroke severity or outcomes at 3 months and the difference was not statistically significant. A higher number of patients with sodium imbalance expired (7 out of 15 i.e 46.6% in the hyponatremia group, 13 out of 34 ie 38.2 % in hypernatremia group; compared to 16 out of 61 i.e 26.2 % in the normal sodium group); this difference though did not show a statistical significance. Conclusion: Electrolyte disturbance is a frequently encountered problem in acute stroke patients, particularly those with a brain stem stroke. The incidence of electrolyte derangements in acute stroke patients appears to be high and, on the other hand, severe stroke cases are found to have the highest rates of dysnatremia, dyskalemia and dyschloremia. Presence of sodium imbalance was found to be related to a higher mortality in stroke patients, though this difference failed to achieve a statistical significance. Moreover, the overall outcomes in the surviving patients were unchanged at three months. Hypernatremia and hypokalemia were more common in hemorrhagic stroke (37%, 42.9%) as compared to ischemic stroke (28%,18.7). The problem necessitates rapid detection of electrolyte imbalance and their careful monitoring, as it may closely affect the short-term prognosis and mortality. [ABSTRACT FROM AUTHOR] |
