Table of Contents
ISRN Stroke
Volume 2013 (2013), Article ID 974236, 5 pages
http://dx.doi.org/10.1155/2013/974236
Research Article

Prognostic Value of Complete Blood Count and Electrolyte Panel during Emergency Department Evaluation for Acute Ischemic Stroke

1Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA
2Department of Emergency Medicine and Neurological Surgery, University of Florida, 1329 SW 16th Street, Suite 4270, Gainesville, FL 32610, USA
3Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA

Received 19 March 2013; Accepted 11 April 2013

Academic Editors: I. M. Benseñor, A. Ducruet, E. Gonzalez-Toledo, and B. Yulug

Copyright © 2013 Latha Ganti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To determine whether routine laboratory parameters are predictors of early mortality after acute ischemic stroke (AIS). Methods. The cohort consisted of 522 consecutive patients with AIS presenting to the emergency department (ED) at a tertiary referral center during a 27-month period, residing within the surrounding ten counties. Serum laboratory values were obtained for all patients and categorized according to whether the levels were low, normal, or high. These laboratory results were evaluated as potential predictors of 90-day mortality using Cox proportional hazards models. The associations were summarized by calculating risk ratios (RRs) and 95% confidence intervals (CI). Results. The presence of elevated white blood cell count (RR 2.2, 95% CI 1.5–3.4), low bicarbonate (RR 4.2, 95% CI 2.6–6.7), low calcium (RR 2.9, 95% CI 1.4–5.9), and high glucose (RR 1.3, 95% 1.1–1.6) were each univariately associated with significantly higher mortality within the first 90 days. Based on fitting a multivariate Cox regression model, elevated white blood cell count, low bicarbonate, and high glucose were each identified as being jointly associated with early mortality ( ). Conclusion. Early leukocytosis, acidosis, and hyperglycemia and hypocalcemia in AIS appear to be associated with early mortality. Whether addressing these factors will impact survival remains to be investigated.