A Study of Serum Fibrinogen Level and Its Prognostic Significance in Patients with Acute Ischemic Stroke

Abstract

INTRODUCTION: One of the leading causes of illness and mortality worldwide is acute ischemic stroke. The incidence seems to always be on the rise due to changing lifestyles. The patient must receive prompt attention and the proper care to survive. Serum fibrinogen level is a prognostic biomarker for acute ischemic stroke patients because they had a higher mortality rate when they admitted with high levels of fibrinogen. Plasma fibrinogen level is a simple marker which can be used to identify patients who are at risk. OBJECTIVES: To study the prognostic importance of serum fibrinogen in acute ischemic stroke in a series of 70 cases. METHODOLOGY: This is a Prospective cross-sectional study, among 70 patients both male and female presenting as Acute Stroke, admitted under the Department of Internal Medicine, Thanjavur Medical College and Hospital, Thanjavur. Relevant clinical history, clinical examinations, biochemical parameters especially the serum fibrinogen levels were compared with the outcomes of the study population. Prognostic value of the serum fibrinogen levels were analysed. RESULTS: The mean Serum Fibrinogen (mg/dl) among the subjects was 396.36 (± 114.68) mg/dl ranging from 60 to 649 mg/dl. The mean Serum Fibrinogen (mg/dl) among Death was significantly higher compared to the subjects who Discharged. Age, smoking, alcoholism, blood pressure, hypertension status, blood sugar, Diabetic status were not associated with Serum Fibrinogen level. Female gender, ischemic stroke, severe cases in Scandinavian Stroke Scale, higher Modified Ranking Score at discharge and admission, had significantly higher levels of Serum Fibrinogen level. The cut off for predicting Outcome is 505 which had a sensitivity of 75%, specificity of 98.39%, positive predictive value of 85.71%, negative predictive value of 96.83% and a diagnostic accuracy of 95.71%. The area under the curve for Serum Fibrinogen (mg/dl) in predicting Outcome is 0.864 (0.637 - 1). CONCLUSION: Serum fibrinogen levels can be used to predict the prognosis in patients affected with acute ischemic stroke