How to Design Economic Predictive Laboratory Panel Evaluating Acute Ischemic Stroke Outcome

Abstract

Background: acute ischemic stroke (AIS) remains the third cause of death and disability, and acute phase responses, both increasing international normalized ratio (INR) and activated partial thromboplastin time (APTT) are associated with worse outcome. Erythrocyte sedimentation rate (ESR) serves as severity marker, and non-fasting triglycerides (TG) indicates remnants of chylomicrons and very low density lipoproteins potentially pro-inflammatory. Aims: to design predictive economic panel evaluating AIS. Patients and methods: 100(AIS) patients were included, clinically evaluated by Scandinavian Stroke Scale (SSS) and Modified Rankin Score (MRS), subjected to complete blood count (CBC) on Cell-Dyne3700, manual ESR, INR and APTT on SYSMEX-CA1500, serum uric acid (SUA), serum albumin and non-fasting (TG) on Beckman Coulter AU480. Statistical analysis: STATA intercooled version 9.2. Results: odd ratio (OR), confidence interval (CI) of (MRS) in correlation to WBCs count in quartile (Q)3, 4 (OR 8.14, CI 2.29 -8.90, significant P = 0.01; and OD13.5, CI 3.39 -53.68, high significant P = 0.001 respectively), to APTT in Q3 (OD 4.15, CI 1.09 -15.82, P = 0.04), SUA in Q3 (OD 0.19, CI 0.05 -0.68, P = 0.01), TG in Q3,4 (OD 0.24 CI 0.06 -0.88, P = 0.03; and OD 0.09, CI 0.02 -0.34 P = 0.001 respectively) and serum albumin in Q3(OD 0.13, CI 0.04 -0.51, P = 0.003), insignificant correlations to ESR, INR and platelets. Conclusion: according to (MRS), the economic predictive panel should be included WBCs, APTT, SUA, and non-fasting TG with serum albumin as prognostic tool evaluating functional disability in AIS.

Blood Biomarkers for Detection of Brain Injury in COVID-19 Patients

“…[181][182][183][184][185][186] Protein biomarkers of CNS damage have also been detected after a variety of acute injury modalities. [193][194][195][196][197][198][199][200][201] Elevations of brain injury biomarkers, including GFAP and ubiquitin C-terminal hydrolase L1 (UCH-L1), have been detected in humans and animals acutely after diverse brain injuries, including TBI, 202,203 ischemic/hemorrhagic stroke, 198 cardiac arrest, 204 hypoxia, 196 seizures, 194 and even drug toxicity. 193 Consistent with these observations, high levels of NSE, S100B, GFAP, and other biomarkers (e.g., neurofilament proteins) can be used to support the prognosis of poor neurological outcome after cardiac arrest, as recommended by the American Heart Association (AHA) Guidelines, and in the recent AHA report on standards for prognostication; serial testing is recommended.…”