Turkish Journal of Physical Medicine and Rehabilitation 2004 , Vol 50 , Num 4

Akut Faz Reaktanları ve Lezyon Büyüklüğünün İnmeli Hastalarda Fonksiyonel Prognoza Etkileri

Ayşenur Taş 1 ,Ece Kaptanoğlu 2 ,Kerim Yılmaz 3 ,Aytekin Akyüz 1 ,Ertuğrul Bolayır 1 ,Suat Topaktaş 1
1 Cumhuriyet Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Sivas
2 Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
3 Cumhuriyet Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı, Sivas

Lesion size and acute phase reactants have been claimed to predict the prognosis in stroke, recently. However, there are contradictory results in the literature. The aim of this study was to evaluate the relationship between the lesion size, acute phase reactants, and early functional outcome after ischemic stroke. In 64 patients with acute ischemic stroke, serum C-reactive protein, fibrinogen and ceruloplasmin levels were studied in the first 24 hours of the event. All patients underwent brain scanning with tomography. Functional status of the patients were evaluated with Barthel Index in the first 24 hours and after 3 months. There was a positive correlation between the 3rd month and 1st day Barthel Index, whereas there was a negative correlation between the 3rd month Barthel Index and C-reactive protein, ceruloplasmin, lesion size and age. There was also a positive correlation between the C-reactive protein level and the lesion size (p<0.05). In the dependent patients according to the 3rd month Barthel Index results, the acute phase reactants, lesion size, and age were significantly greater and the 1st day Barthel score was significatly lower than the independent group (p<0.001, Mann Whitney U). When 3rd month Barthel Index was used as final outcome (as dependent and independent groups), multiple logistic regression analysis identified ceruloplasmin (OR, 4,8; 95% CI , between 24,04 and 9,72; p=0,029) and lesion size (OR, 2,7; 95% CI, between 1,17 and 6.34; p=0,019) as independent predictors of outcome. In conclusion, lesion size and ceruloplasmin may be accepted as indicators of short-term prognosis in patients with ischemic stroke.

Keywords : Stroke, lesion size, acute phase reactants, ceruloplasmi