Association of Serum Bilirubin with Acute Ischemic Stroke – An Observational Study
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Abstract
Introduction: Stroke is a common cause of mortality and morbidity and has an increasing prevalence across the world.1 Bilirubin is now being considered an antioxidant which increases in response to diseases associated with increased oxidative stress. Hence the present observational study was undertaken to assess the bilirubin levels with the outcome of acute ischemic stroke. Methods: This observational study was conducted from January 2018 to December 2018 on 64 ischemic stroke patients admitted at KLE’S Dr. Prabhakar kore hospital at Belagavi, Karnataka. All adult patients above 18 years of age presenting with cerebrovascular accident and proved as ischemic stroke on CT scan or MRI scan were included. The patients were empirically divided into different Groups based on the bilirubin level. They were then analysed with their NIHSS scores for assessing stroke severity. Results: A total of 64 patients were included in the final analysis. The mean total bilirubin level in the patients was 0.68±0.34 mg/dl (mean±SD). 34.3% (22) of ischemic stroke patients in the study had serum total bilirubin levels 0.7 mg/dl or more. Mean NIHSS Score for Group 1(Low) total bilirubin group was 9.37 and for Group 2(High) bilirubin group was 10.9, which was statistically not significant. This indicates that there was no significant correlation between total bilirubin and severity of symptoms at the time of admission.There was no statistically significant correlation between NIHSS and direct bilirubin levels Conclusion: The current study has documented no association between the bilirubin levels and stroke severity and prognosis.
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Global Health Estimates. Geneva: World Health Organization; 2012. Available from: http://www.who.int/healthinfo/global_burden_disease/en/ [cited 2016 June 1].
Luo, Yun & Li, Jing-Wei & Lu, Zheng-Juan & Wang, Chong & Guan, De-Ning & Xu, Yun. (2012). Serum Bilirubin after Acute Ischemic Stroke is Associated with Stroke Severity. Current neurovascular research. 9. 128-32. doi:10.2174/156720212800410876.
Pineda, Sandra & Bang, Oh Young & Saver, Jeffrey &Starkman, Sidney & W Yun, Susan &Liebeskind, David & Kim, Doojin& Sharma, Latisha & H Shah, Samir &Ovbiagele, Bruce. (2008). Association of Serum Bilirubin with Ischemic Stroke Outcomes. Journal of stroke and cerebrovascular diseases:the official journal of National Stroke Association. 17. 147-52. doi:10.1016/j. jstrokecerebrovasdis.2008.01.009.
UN Chronicle Health Watch. Atlas of Heart Disease and Stroke. 2005; 0105: 46.
Warlow C, Sudlow C, Dennis M, Wardlaw J, Sandercock, P. Stroke. Lancet 2003; 362: 1211–24.
Reddy K, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation 1998; 97:596–601.
Wang L , Bautista LE . Serum bilirubin and the risk of hypertension. Int J Epidemiol 2015;44:142–52.
Kunutsor SK , Bakker SJL , Gansevoort RT , et al. Circulating total bilirubin and risk of incident cardiovascular disease in the general population. Arterioscler Thromb Vasc Biol 2015;35:716–24
Population-Based Stroke Survey in Mumbai, India: Incidence and 28-Day Case Fatality - Abstract - Neuroepidemiology 2008, Vol. 31, No. 4 - Karger Publishers [Internet]. Available from: http://www.karger.com/Article/Abstract/165364
Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja P N, Nayak SD, Sarma PS, et al. Incidence, Types, Risk Factors, and Outcome of Stroke in a Developing Country. Stroke. 2009 Apr 1 1212—8.
Nagaraja D, Gururaj G, Girish N, Panda S, Roy AK, Sarma GRK, et al. Feasibility study of stroke surveillance:Data from Bangalore, India. http://icmr.nic.in/ijmr/2009/October/1007.pdf [Internet]. 2009.
Paciaroni M, Silvestrelli G, Caso V, Corea F, Venti M, Milia P, Tambasco N, Parnetti L, Gallai V, et al. Neurovascular territory involved in different etiological subtypes of ischemic stroke in the perugia Stroke Registry. European Journal of Neurology 2003, 10: 361—365.
Grace M , Jacob KJ, Arya Vijay Kumar, Shameer V. K, et al. Role of dyslipidemia in stroke and comparison of lipid profile in ischemic and hemorrhagic stroke -a case control study. Int J Adv Med. 2016 Aug;3(3):694- 698.
Siddeswari R, Manohar S, Sudarsi B, Suryanarayana B, Shravan kumar P, AbhiIashT. Pattern of dyslipidemia in ischemic stroke. J Med Allied Sci 2015;
Ademiluyi B, SanyaE , Wahab K et al. Relationship Between Admission Serum Bilirubin and Severity of Acute Ischemic Stroke in a Nigerian Tertiary Hospital. Neurology. April 5, 2016; vol. 86 no. 16 Supplement P5.239.
Arsalan H, Ismail M, Khattak MB, Anwar MJ, Murtaza Z, Khan F. PROGNOSTIC SIGNIFICANCE OF SERUM BILIRUBIN IN STROKE. J. Ayub Med Coll Abbottabad,2011 ;23(2)
Pineda, Sandra & Bang, Oh Young & Saver, Jeffrey &Starkman, Sidney & W Yun, Susan & Liebeskind, David & Kim, Doojin& Sharma, Latisha & H Shah, Samir &Ovbiagele, Bruce. (2008). Association of Serum Bilirubin with Ischemic Stroke Outcomes. Journal of stroke and cerebrovascular diseases:the official journal of National Stroke Association. 17. 147-52. doi:10.1016/j.jstrokecerebrovasdis.2008.01.009.65.
Perlstein TS, Pandora RL, Creager MA, Weuve J, Beckman JA. Serum total bilirubin level , prevalent stroke, and stroke outcomes: NHANES 1999-2004 Am J Med 2008 ; 121 :781-8e1