Serum Cortisol Levels in Assessing the Severity of Acute Stroke: A Cross Sectional study in Chengalpattu Medical College and Hospital

Abstract

INTRODUCTION: The stress response that occurs after the event of acute stroke causes the activation of the hypothalamo–pituitary–adrenal (HPA) axis. Certain studies have found that increased serum cortisol level in patients with acute stroke is related to greater stroke severity. Whether the stress response is just an epiphenomenon to stroke severity or independently contributes to prognosis remains uncertain. But there is a immense need to detect a biomarker for predicting the outcome of acute stroke. OBJECTIVE OF THE STUDY: The aim of the study was to investigate if a single serum cortisol determination was related to severity of acute stroke. METHODS: A cross sectional study was conducted in 120 patients with acute stroke presenting within 24 hours of stroke onset after getting informed consent. The patients were studied from medical wards and IMCU in Chengalpattu government hospital. Scandinavian Stroke Scale (SSS) was used to study severity of acute stroke. Diagnosis of Acute Ischemic or Hemorrhagic stroke was based on CT imaging in all patients. Blood samples are taken for assessing serum cortisol levels. Data was entered in MS excel analyzed using SPSS software for appropriate descriptive and inferential statistics. RESULTS: The mean age group is 50 to 59 years with 50% males and 50 % females. The mean cortisol level was 637nmol/L. Of the 120 cases 98 had acute ischemic stroke and 22 had acute hemorrhagic stroke. The mean SSS score was 20.85 and mean time duration was 9.5 hours. The correlation coefficient for SSS and serum cortisol was -0.984 which had significant correlation indicating high serum cortisol levels had low SSS score and also the P value being < 0.001 which was statistically significant. CONCLUSION: Acute stroke severity related to increasing serum cortisol levels. Serum cortisol was associated with stroke severity and markers reflecting stroke severity