Fibrinogen as a Predictor of Early Neurological Deterioration in Acute Ischemic Stroke – Evidence From the Indian Population

Abstract

Background: Early neurological deterioration (END) is a common occurrence in ischemic stroke and contributes significantly to poor outcomes. Although multiple factors that predict END have already been identified, the role of fibrinogen – a key component of the coagulation pathway, is controversial. Objective: To assess the role of fibrinogen in predicting END and poor hospital outcome in patients with acute ischemic stroke. Design: Single-centre prospective observational study. Methods: 141 patients with acute ischemic stroke were analyzed in this prospective observational study from a single tertiary-care hospital in East India. END was defined as a worsening of ≥2 points on the National Institutes of Health Stroke Scale (NIHSS) within 7 days of admission. A score of 3-5 on the Modified Rankin Scale (mRS), a stroke recurrence event or death during hospital stay was considered poor hospital outcome. We performed univariate analysis using age, sex, body-mass index (BMI), hypertension, diabetes, NIHSS scores, stroke etiology, blood glucose and lipid parameters and plasma fibrinogen to develop a logistic regression model to establish the independent predictors of END and poor outcome. Results: Age (Odds Ratio (OR) 1.034 [95% CI 1.001-1.069], P =.046), NIHSS score at admission (OR 1.152 [95% CI 1.070-1.240], P