Hypoalbuminemia in acute ischemic stroke patients: frequency and correlates

Dziedzic, Tomasz; Pera, Joanna; Słowik, Agnieszka; Gryz-Kurek, Elzbieta; Szczudlik, Andrzej

doi:10.1038/sj.ejcn.1602643

Cited by 48 publications

(29 citation statements)

References 25 publications

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“…In hypoalbuminemia, a common state in stroke patients that predicts poor outcome [9], hypocalcemia is common because of the decrease in the fraction bound to albumin, although the bioactive ionized calcium levels may be in the normal range. In order to neutralize the effect of albumin on calcium level several formulas have been developed [8,10,11].…”

Section: Introductionmentioning

confidence: 99%

Serum Calcium Levels and Long-Term Mortality in Patients with Acute Stroke

et al. 2010

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Background: Calcium concentrations in serum are maintained within an exquisitely narrow range. Our aim was to examine the association between serum calcium and albumin-adjusted calcium (calcium_adj) levels and stroke outcome in a cohort of unselected patients with acute stroke. Methods: Consecutive patients hospitalized due to acute stroke (ischemic or intracerebral hemorrhage) throughout a large medical center were systematically assessed and followed for 1 year. Baseline total calcium and calcium_adj levels were collapsed into groups of low (<8.6 mg/dl), normal (8.7–9.9 mg/dl) and high (>10 mg/dl) levels and linear and quadratic relations with outcome were examined. Result: Among 784 patients (mean age 70.7 ± 12.5 years, 42.5% females), the mean ± SD total calcium level was 9.3 ± 0.6 mg/dl. For total calcium, the adjusted hazard ratio (HR) for all-cause death over 1 year was 1.83 [95% confidence interval (CI) 1.22–2.75] among patients with low versus normal levels. For calcium_adj, the adjusted HR for all-cause death among women was over 3-fold higher among patients with high calcium_adj levels versus those with normal levels (3.31; 95% CI 1.70–6.46), while no such associations were observed among men. In models developed to estimate the linear and quadratic relations, each unit increment in total calcium squared was associated with an increased adjusted HR of all-cause death over 1 year (p = 0.02) confirming nonlinear associations, and each unit increment in calcium_adj squared was associated with an increased adjusted HR of all-cause death over 1 year among women (p < 0.001) but not among men (p = 0.70). Conclusions: Serum calcium concentrations are a marker of mortality in acute stroke patients, but the associations are not linear, increasing at both extremes of calcium levels. Our findings suggest that long-term survival is optimal in a distinct range of serum calcium levels.

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Section: Introductionmentioning

confidence: 99%

Serum Calcium Levels and Long-Term Mortality in Patients with Acute Stroke

et al. 2010

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“…Hypoalbuminemia is a frequent finding in acute stroke patients, and it was associated with more severe stroke. Additionally, a negative correlation was detected between serum albumin level and the degree of neurological deficit (10) . Hypoalbuminemia in acute stroke patients could be a result of malnutrition, underlying disease processes like renal or hepatic insufficiency, uncontrolled heart failure or malignancy (10) .…”

Section: Discussionmentioning

confidence: 95%

“…Hypoalbuminemia was recently studied by a group of researchers in Poland. The research assessed albumin level in 705 acute ischemic stroke patients with firstever ischemic stroke admitted to the stroke unit within 24 h after stroke onset (10) . A high frequency of hypoalbuminemia in acute stroke patients was noticed.…”

Section: Discussionmentioning

confidence: 99%

Ischemic Cerebral Stroke Case Report, Complications and Associated Factors

Shahin¹

2017

IAM

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Cerebral stroke (CVA) is a medical emergency that can cause permanent neurological damage or even death. According to the WHO statistics, stroke was the second most frequent cause of death worldwide in 2012 and the main cause of disability. The present study reported 82 year-old female case admitted to the medical department of the Jordan University Hospital through the ER with hypertension, right side weakness, global aphasia, tongue heaviness, dysphagia and was diagnosed with ischemic stroke. Even though more data is emerging about CVA, more efforts are needed to understand risk factors, treatment options, associated complications and stroke-related complications. In this case, the treatment options were discussed as well as some complications associated with ischemic cerebral stroke. In conclusion, post-stroke infection is common among hospitalized patients as a result of compromised immunity; however, this infection may take different forms like pneumonia, urinary tract infection or other forms of infections. Utilizing proper measures for prevention, early detection and management using proper antibiotics are of vast importance for patients post cerebral stroke. On the other hand, Gallbladder stones and cholecystitis are common complications developed after cerebral stroke and prolonged immobility for bedridden patients. CK-MB elevation post stroke is not likely to be of a cardiac origin.

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“…Serum albumin has also been shown to act as a neuroprotector in animal models and clinical trials [6][7][8][9]. Notably, hypoalbuminemia can occur in up to 45.5% of AIS patients [10]. However, only one study has investigated the relationship between serum albumin and HT [11], and in that previous work, the authors focused on patients undergoing intravenous thrombolysis.…”

Section: Serum Albumin Is Negatively Associated With Ht In Ais Patientsmentioning

confidence: 94%

Serum Albumin Is Negatively Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients

et al. 2019

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Background and Objective: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke (AIS). Serum albumin is known for its neuroprotective effects and is a marker of improved AIS patient outcomes. However, it is not known whether there is a relationship between serum albumin and HT. Methods: AIS patients admitted to the Department of Neurology of West China Hospital from 2012 to 2016 were prospectively and consecutively enrolled. Baseline characteristics were collected. HT during hospitalization was diagnosed by brain imaging. Multivariate logistic regression analysis was performed to determine the relationship between serum albumin and HT. Confounding factors were identified by univariate analysis. Stratified logistic regression analysis was performed to identify effect modifiers. Results: A total of 1996 AIS patients were recruited, of whom 135 (6.8%) developed HT. Serum albumin negatively correlated with HT. Patients in the upper serum albumin tertile (42.6–54.1 g/L) had a 46% lower risk of HT than patients in the lower tertile (19.3–39.1 g/L) after adjustment for potential confounders (OR 0.54, 95% CI 0.29–0.99, p = 0.04). Risk of HT decreased stepwise with higher serum albumin tertile (p for trend = 0.04). There was a significant interaction between serum albumin and age (p = 0.02), with no significant correlation between serum albumin and HT in patients over 60 years of age. Conclusions: Higher serum albumin is associated with lower HT risk in a dose-dependent manner in AIS patients younger than 60 years.

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Hypoalbuminemia in acute ischemic stroke patients: frequency and correlates

Cited by 48 publications

References 25 publications

Serum Calcium Levels and Long-Term Mortality in Patients with Acute Stroke

Serum Calcium Levels and Long-Term Mortality in Patients with Acute Stroke

Ischemic Cerebral Stroke Case Report, Complications and Associated Factors

Serum Albumin Is Negatively Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients

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