LOW TOTAL CHOLESTEROL SERUM LEVELS AS A POOR OUTCOME PREDICTOR FOR INTRA-CEREBRAL HEMORRHAGE STROKE

I Gusti Agung Gede Ariswanda, I Made Oka Adnyana, I Putu Eka Widyadharma, A A B N Nuartha, A A A Putri Laksmidwei, I Komang Arimbawa
  MNJ, pp. 69-72  

Abstract


Background: Stroke is affected by several factors, age, infection during treatment, obesity, and total cholesterol (TC) levels.  

Objective: The study aimed to prove low TC serum levels as an unfortunate outcome predictor for intracerebral hemorrhage stroke. 

Methods: This study is a prospective cohort design. The research did in the Stroke Unit of Sanglah Hospital, Denpasar, from July 1st, 2018 to January 31th, 2019. The study involved patients with hemorrhage strokes with low TC serum levels and aged 40-95 years. Depending on variable divided into two groups with low TC serum levels (<180 mg/dL) and normal TC serum levels (>180mg/dL). Independent variable is The National Institutes of Health Stroke Scale (NIHSS) as an outcome. The processing of data analysis using Mac for SPSS version 23. 

Result: This study used 70 subjects. The age characteristics of the study subjects with a median value of 62 years in for low TC levels, and 57 years for normal TC levels, dominant in male (60% ), working (71.5%), not obese (58.6%), stroke-related infections (51.4%), and mean arterial blood pressure (MABP) £130mmHg (90%). Subjects with low TC had a risk of 64 times experiencing adverse outcomes (RR = 64: CI 95% = 14.06-291.32: p <0.001). Multivariate analysis showed a low TC serum level as an independent variable.

Conclusion: Low TC serum levels as an independent predictor having a poor outcome in intracerebral hemorrhage stroke


Keywords


Intracerebral hemorrhage stroke, low total cholesterol, poor outcome

Full Text:

PDF

References


Chen YW, Li CH, Yang CD, Liu CH, Chen CH, Sheu JJ, et al. Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage: Results from Taiwan Stroke Registry. PloS one; 2017. 12(4):1-15. DOI: 10.1371/journal.pone.0171379

Wangi, Widyadharma, Adnyana. proporsi dan karakteristik penderita stroke di unit stroke Nagasari RSUP Sanglah Denpasar periode Januari 2012-Desember 2014 - Google Search [Internet]. [cited 2019 Jun 30].

Wong GKC, Lam SW, Poon WS. Long Term Outcome after Hemorrhagic Stroke Surgery (LOMSS) in Hong Kong Chinese. Journal of Advances in Medicine and Medical Research; 2013. 182–88. DOI: 10.9734/BJMMR/2013/1717

Russell MW, Joshi AV, Neumann PJ, Boulanger L, Menzin J. Predictors of hospital length of stay and cost in patients with intracerebral hemorrhage. Neurology; 2006. 67(7):1279–81.

DOI: 10.1212/01.wnl.0000238349.28146.46

Kazemnejad-Leili E, Rezaei S, Hosseini-Nejad M, Bakhshayesh-Eghbali B, Saberi A, Keshavarz P. the applicability, concurrent validity and internal consistency reliability of the persian version of the National Institutes of Health Stroke Scale (NIHSS): evidences for gender differences. Caspian Journal of Neurological Sciences; 2016. Mar;1(2):18–8.

DOI: 10.18869/acadpub.cjns.2.4.18

Ramírez-Moreno JM, Casado-Naranjo I, Portilla JC, Calle ML, Tena D, Falcón A, et al. Serum cholesterol LDL and 90-day mortality in patients with intracerebral hemorrhage. Stroke; 2009. May;40(5):1917–20.

DOI: 10.1161/STROKEAHA.108.536698

Roquer J, Campello AR, Gomis M, Ois A, Munteis E, Böhm P. Serum lipid levels and in-hospital mortality in patients with intracerebral hemorrhage. Neurology; 2005. 65(8):1198–1202.

DOI: 10.1212/01.wnl.0000180968.26242.4a

Setianto CA, Purnomo H, Marhaendraputro EA, Santoso WM. Correlation of c-reactive protein levels with clinical outcome intracerebral hemorrhage stroke patients. Malang Neurology Journal; 2015. 1(1):23–7. Available from: https://mnj.ub.ac.id/index.php/mnj/article/view/19

Raisa N, Sujuti H, Purnomo H, Rahayu M, Dalhar M. The influence of sampling time to serum Glial Fibrillary Acidic Protein (GFAP) levels in acute stroke. Malang Neurology Journal; 2018. 5(1):30–3. Available from: https://mnj.ub.ac.id/index.php/mnj/article/view/358

Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: A meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet;

2010. Nov;376(9753):1670–81. DOI: 10.1016/S0140-6736(10)61350-5

Iribarren C, Reed DM, Burchfiel CM, Dwyer JH. Serum total cholesterol and mortality. Confounding factors and risk modification in Japanese-American men. JAMA; 1995. Jun 28;273(24):1926–32. Avalaible from : https://www.ncbi.nlm.nih.gov/pubmed/7783302

Huhle G, Abletshauser C, Mayer N, Weidinger G, Harenberg J, Heene DL. Reduction of platelet activity markers in type II hypercholesterolemic patients by a HMG-CoA-reductase inhibitor. Thrombosis research; 1999. 95(5):229–34. DOI: 10.1016/s0049-3848(99)00037-7

Kaneider NC, Egger P, Dunzendorfer S, Wiedermann CJ. Rho-GTPase–Dependent Platelet-Neutrophil interaction affected by HMG-CoA reductase inhibition with altered adenosine nucleotide release and function. Arteriosclerosis, Thrombosis, And Vascular Biology; 2002. 22(6):1029–35.

DOI: 10.1161/01.ATV.0000018306.68268.86

Jellinger P, Smith D, Mehta A, Ganda O, Handelsman Y, Rodbard H, et al. American Association of Clinical Endocrinologists’ guidelines for management of dyslipidemia and prevention of atherosclerosis. Endocrine practice; 2012.18(Supplement 1):1–78.

DOI: 10.4158/ep.18.s1.1

Munir B, Rasyid HA, Rosita R. Relationship between the random blood glucose levels during admission at emergency room with clinical output in acute ischemic stroke patients. Malang Neurology Journal; 2015 Jun;1(2):52–60. Available from: https://mnj.ub.ac.id/index.php/mnj/article/view/21

Cheung CM, Tsoi TH, Hon SF, Au-Yeung M, Shiu KL, Lee CN, et al. Using the National Institutes of Health Stroke Scale (NIHSS) to predict the mortality and outcome of patients with intracerebral haemorrhage. Hong Kong Med J; 2008.14(5):367–370. Avalaible from: https://www.ncbi.nlm.nih.gov/pubmed/18840907


Refbacks

  • There are currently no refbacks.