The Brain Ischemic Volume Correlation with the Ischemic Modified Albumin Level

Objective: Cerebrovascular disease is a frequent cause of emergency department visits, and early diagnosis can reduce mortality and morbidity. It was aimed to evaluate the relationship between diffusion-weighted-magnetic resonance imaging (DW-MRI) and blood ischemic modified albumin (IMA) levels of cerebrovascular diseases in terms of demographic characteristics, mortality, and morbidity. Method: This prospective cohort study included 44 patients diagnosed with ischemic stroke in the emergency room between January and July 2014 and 44 people in the control group. Age, gender, vital signs, co-morbid disease states, neurological deficit levels, IMA levels, DW-MRI involvement volumes, and mortality rates were analyzed in patients who were diagnosed with stroke and who had DW-MRI restrictions. Also, a control group of 44 volunteers who applied to our emergency department was added to compare the IMA level. Results: The median age of the patients was 71 years (24 males, 20 females, range 47 to 83 years) and the median age of the control group was 68 (25 males, 19 females, range 52 to 79) years. The median age of the control group was close to that of the patient group, the two groups were also similar in terms of gender distribution. The most common co-morbid disease was hypertension 28 (63.6%), atrial fibrillation (AF) 14 (31.8%), diabetes mellitus (DM) 10 (22.8%) and coronary artery disease 10 (22.8%). The median value of the IMA level was 13.84 in the patient group and 8.66 in the control group. While the patients’ NIHSS stroke score was high, the area of involvement in MRI and also IMA levels increased. Besides, diffusion involvement area and IMA levels were positively and moderately correlated. Conclusion: IMA level can be considered as a parameter that can be used in acute ischemic stroke and as an indicator of the diffusion restriction area in MRI

İskemik Beyin Hacminin İskemik Modifiye Albümin Seviyesi ile Korelasyonu

Amaç: Serebrovasküler hastalık, acil servis başvurularının sık bir nedenidir, erken tanı mortalite ve morbiditeyi azaltabilir. Çalışmamızda serebrovasküler hastalıkların difüzyon ağırlıklı-manyetik rezonans görüntülemeleri (DA-MRG) ile kan iskemik modifiye albümin (İMA) düzeyleri arasındaki ilişkinin demografik özellikler, mortalite ve morbidite açısından değerlendirilmesi amaçlandı. Yöntem: Bu prospektif kohort çalışmasına Ocak-Temmuz 2014 tarihleri arasında acil serviste iskemik inme tanısı almış 44 hasta ile 44 kontrol grubu dahil edildi. İnme tanısı konulan ve DA-MRG kısıtlaması olan hastalarda yaş, cinsiyet, yaşamsal belirtiler, yandaş hastalık durumları, nörolojik defisit düzeyleri, İMA düzeyleri, DA-MRG tutulum hacimleri ve mortalite oranları analiz edildi. Ayrıca, İMA düzeyini karşılaştırmak için acil servisimize başvuran 44 gönüllüden oluşan bir kontrol grubu eklenmiştir. Bulgular: Hastaların ortalama yaşı 66,98±16,36 ve %54,5’i (n=24) erkekti. Kontrol grubu ile hasta grubunun yaşları benzerdi. En sık görülen komorbid hastalık hipertansiyon 28 (%63,6); atriyal fibrilasyon 14 (%31,8), diabetes mellitus 10 (%22,8) ve koroner arter hastalığı 10 (%22,8) idi. İMA düzeyinin ortanca değeri hasta grubunda 13,84, kontrol grubunda 8,66 idi. Hastaların NIHSS inme skoru yüksek iken, MRG’deki tutulum alanı ve ayrıca İMA seviyelerinin arttığı görüldü. Ayrıca difüzyon kısıtlama alanı ve İMA düzeyleri pozitif ve orta düzeyde ilişkiliydi. Sonuç: İMA düzeyi, akut iskemik inmede kullanılabilen bir parametre ve DA-MRG’de kısıtlılık alanının bir göstergesi olarak değerlendirilebilir.

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