Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Globally, stroke is the major cause of both morbidity and mortality. Serum calcium appears to be indirectly a measure of severity of acute ischemic stroke. The NIHSS score appears to be a widely used tool in assessment of severity of stroke. A score of less than five denotes a minor score., scores of five to fifteen indicate a moderate stroke., scores of sixteen to twenty indicate a moderate to severe stroke and scores of twenty to forty‐two indicate a severe stroke. With regard to the NIHSS score and infarct size in acute ischemic stroke, this study intends to assess the usefulness of blood calcium as a useful marker for assessment of ischemic stroke severity. This cross‐sectional study was conducted at a tertiary hospital between September 2022 and June 2024.It included 60 patients of age greater than 18 years presenting within 48 hours of onset of acute ischemic stroke and excluded cerebral venous thrombosis, posterior circulation stroke, hepatic and renal disease and patients on calcium supplements. Patients were evaluated based on clinical history, physical examination and lab parameters like complete hemogram, liver function tests and renal function tests. Radiologically patients were evaluated by MRI of brain to assess infarct size. Sims et al. provided the formula for the analysis of the infarct size. The NIHSS score was determined and is interpreted as follows: 0 represents no stroke symptoms, 1‐4 represents a small stroke, 5‐15 represents a moderate stroke, 16‐20 represents a moderate to severe stroke and 21–42 represents a severe stroke. P values less than 0.05 on two‐tailed significance were deemed statistically significant, while P values less than 0.01 were deemed highly significant. The patient’s average age ranged from 60 to 80 years old, with the majority of them being male (66.7%). The study population showed hypertension (38.3%) as a more common risk factor than type 2 diabetes mellitus (5%) and the majority had no comorbidities at the time of presentation. The mean serum calcium level was 8.710 with standard deviation of 0. 4711.The mean infarct size was 62.95125cm3 with standard deviation of 73. 3737cm3.The mean NIHSS score was 9.88 with standard deviation of 5.737. The majority of the patients were in moderate severity stroke severity category (65%). The study showed a moderate negative correlation between serum calcium and NIHSS score (r=‐0.829) and was statistically significant (p value= <0.001). The study showed a moderate negative correlation between serum calcium and infarct size (r=‐0.711) and was statistically significant (p value=<0.001). Serum calcium in this study showed a significant negative connection with the infarct's magnitude as well as the NIHSS score. Serum calcium levels will drop as clinical deterioration occurs as indicated by the NIHSS score which will rise in an acute ischemic stroke with larger infarct sizes because more calcium will be shifted from the extracellular to the intracellular area. So, blood calcium levels can be used as a prognostic indicator for acute ischemic stroke.
How to cite this article:
Channamallappa Patil, Shashidhar S. Devarmani, Shridhar Patil and M.K. Anuja. Correlation of Serum Calcium, Infarct Size and NIHSS Score in Acute Ischemic Stroke.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.11.459.462
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.11.459.462