ELECTROLYTE DISTURBANCE IN HEMORRHAGIC AND NON-HEMORRHAGIC STROKE PATIENTS IN AL-DIWANIYAH TEACHING HOSPITAL

Aqeel Raheem Hassan; Zahraa Adel Aryan

doi:10.22159/ajpcr.2018.v11i11.29173

Authors

Aqeel Raheem Hassan Department of Internal Medicine, College of Medicine, University of AL-Qadisiyah, Diwaniyah, Iraq.
Zahraa Adel Aryan Department of , Al-Dewaniyah Teaching Hospital, Al-Dewaniyah Province, Iraq.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i11.29173

Keywords:

Stroke, Electrolyte Disturbance, Sodium, Potassium

Abstract

Objectives: Although there are many studies on stroke, few studies on electrolyte disturbance have been done in our country, even on the outside. Our aim in this study is to estimate the level of serum potassium and sodium in acute stroke patients with comparison to patients of the control group.

Methods: Our study is a comparative cross-sectional study conducted on patients in the neurological center who suffer from stroke and others in medicine department admitted for any disease other than cerebrovascular accidents (CVA) they consider the control group. All were in AL-Diwaniyah Teaching Hospital from April to July 2018. The level of potassium and sodium from all patients is estimated. Patients with ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA) were classified into having Glasgow coma scores (GCS) of 3â€“8, 9â€“12, and 13â€“15, respectively.

Result: Significant difference was seen in the distribution of patients according to GCS levels (p=0.014). Mean serum sodium was significantly lowest in hemorrhagic stroke, then ischemic stroke, followed by TIA, and the highest sodium level was seen in the control group (p<0.001). Mean serum potassium was significantly lowest in hemorrhagic stroke, then ischemic stroke, followed by TIA, and the highest sodium level was seen in the control group (p<0.001). Mean serum-to-potassium ratio was significantly highest in hemorrhagic stroke, then TIA, followed by ischemic stroke, and finally, by control group (p<0.001).

Conclusion: This study reveals that, in hemorrhagic stroke, the incidence of electrolytes imbalance was more than ischemic and which was mostly hyponatremia and hypokalemia.

Downloads

Download data is not yet available.

References

Goldstein LB, Adams R, Alberts MJ, Appel LJ, Brass LM, Bushnell CD, et al. Primary prevention of ischemic stroke: A guideline from the American heart association/American stroke association stroke council: Cosponsored by the atherosclerotic peripheral vascular disease interdisciplinary working group; cardiovascular nursing council; clinical cardiology council; nutrition, physical activity, and metabolism council; and the quality of care and outcomes research interdisciplinary working group: The American academy of neurology affirms the value of this guideline. Stroke 2016;37:1583-633.

Broderick J, Connolly S, Feldmann E, Hanley D, Kase C, Krieger D, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults 2007 update. Stroke 2007;38:2001-23.

Hankey GJ. Potential new risk factors for ischemic stroke. What is their potential? Stroke 2006;37:2181-8.

National Institutes of Health. Adult treatment panel III: Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Bethesda, MD. National Institutes of Health; 2002.

Megherbi SE, Milan C, Minier D, Couvreur G, Osseby GV, Tilling K, et al. Association between diabetes and stroke subtype on survival and functional outcome 3 months after stroke: Data from the European BIOMED stroke project. Stroke 2003;34:688-94.

Wang GQ, Sun W, Wells GA, Li Z, Li T, Wu J. Baseline study on a stroke-related cohort in the rural community of Shanghai. Zhonghua Liu Xing Bing Xue Za Zhi 2006;27:12-4.

Tseng CH, Chong CK, Sheu JJ, Wu TH, Tseng CP. Prevalence and risk factors for stroke in Type 2 diabetic patients in Taiwan: A crosssectional survey of a national sample by telephone interview. Diabetic medicine: J Br Diabet Assoc 2005;22:477-82.

Al-Rubeaan K, Youssef AM, Subhani SN, Ahmad NA, Meves SH, Diehm C, et al. Ischemic stroke and its risk factors in a registry-based large cross-sectional diabetic cohort in a country facing a diabetes epidemic. J Diabetes Res 2016;4:132-589.

Palm F, Urbanek C, Wolf J, Buggle F, Kleemann T, Hennerici MG. Etiology, risk factors and sex differences in ischemic stroke in the Ludwigshafen stroke study, a population-based stroke registry. Cerebrovasc Dis (Basel, Switzerland) 2012;33:69-75.

Geddes JM, Fear J, Tennant A, Pickering A, Hillman M, Chamberlain MA, et al. Prevalence of self-reported stroke in a population in northern England. J Epidemiol Community Health 1996;50:140-3.

Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Benjamin EJ, et al. Heart disease and stroke statistics-2016 update: A report from the American heart association. Circulation 2016;133:e38â€‘60.

Orlandi G, Gelli A, Fanucchi S, Tognoni G, Acerbi G, Murri L. Prevalence of stroke and transient ischaemic attack in the elderly population of an Italian rural community. Eur J Epidemiolo 2003;18:879-82.

Boix R, del Barrio JL, Acosta J, Bergareche A, Bermejo-Pareja F, Gabriel R, et al. Stroke prevalence among the Spanish elderly: An analysis based on screening surveys. BMC Neurol 2006;6:36.

Alam MN, Uddin MJ, Rahman KM, Ahmed S, Akhtar M, Nahar N, et al. Electrolyte changes in stroke. Mymensingh Med J 2012;21:594-9.

Kusuda K, Saku Y, Sadoshima S, Kozo I, Fujishima M. Disturbances of fluid and electrolyte balance in patients with acute stroke. Nihon Ronen Igakkai Zasshi 2011;26:223-7.

Qureshi AI, Suri MF, Sung GY, Straw RN, Yahia AM, Saad M, et al. Prognostic significance of hypernatremia and hyponatremia among patients with aneurysmal subarachnoid hemorrhage. Neurosurgery 2002;50:749-55.

Chandy D, Sy R, Aronow WS, Lee WN, Maguire G, Murali R. Hyponatremia and cerebrovascular spasm in aneurismal subarachnoid hemorrhage. Neurol India 2006;54:273-5.

Sherlock M, Oâ€™Sullivan E, Agha A, Behan LA, Rawluk D, Brennan P, et al. The incidence and pathophysiology of hyponatremia after subarachnoid hemorrhage. Clin Endocrinol (Oxf) 2012;64:250-4.

McGirt MJ, Blessing R, Nimjee SM, Friedman AH, Alexander MJ, Laskowitz DT, et al. Correlation of serum brain natriuretic peptide with hyponatremia and delayed ischemic neurological deficits after subarachnoid hemorrhage. Neurosurgery 2004;54:1369-73.

Cheng CJ, Kuo E, Huang CL. Extracellular potassium homeostasis: Insights from hypokalemic periodic paralysis. Semin Nephrol 2013;33:237-47.

Gariballa SE, Robinson TG, Fotherby MD. Hypokalemia and potassium excretion in stroke patients. J Am Geriatr Soc 1997;45:1454-58.

Fofi L, Dallâ€™armi V, Durastanti L, Valenza A, Lorenzano S, Prencipe M. An observational study on electrolyte disorders in the acute phase of ischemic stroke and their prognostic value. J Clin Neurosci 2012;19:513-6.

Hidayah K, Zullies I, Abdul G. Adherence to secondary stroke prevention therapies in ischemic stroke patients at teaching hospital in Central Java Indonesia. Asian J Pharm Clin Res 2017;5:28-30.

Ketut W, Putri LA, Eka P. The aspect of neurocognitive and rehabilitation on alexia without agraphia case. Asian J Pharm Clin Res 2018;11:4-6.