Altered Serum Electrolyte Status in Acute Stroke Patients in Western Odisha, A Predictor of Syndrome of Inappropriate ADH (SIADH) or Cerebral Salt Wasting Syndrome (CSWS)

摘要

Stroke is a major healthcare issue globally with an incidence comparable to coronary events. It has multiple aetiologies and variable clinical manifestations. Dyselectrolytaemia is an important cause of morbidity and mortality in stroke.Aim: To observe the changes in serum electrolyte levels in Cerebrovascular Accident (CVA) patients and to find any relation with other biochemical parameters and type of stroke.Materials and Methods: A total of 60 clinically diagnosed and CT/MRI proven acute stroke patients (ischaemic/haemorrhagic) in age group 40-70 years were studied in the Department of Biochemistry, VIMSAR, Burla, for a duration of two years (September 2013 to August 2015). Control group consisted of 50 age and sex matched individuals. Serum electrolytes, urea, creatinine, fasting blood glucose, age, BMI and other parameters were studied in these patients.Results: Out of 60 patients 41 (68%) were males and 19 (32%) were females. Maximum number of cases had ischaemic stroke (62%) followed by haemorrhagic stroke (38%). Mean serum level of sodium was lower in cases as compared to the controls which was statistically significant (p<0.0001). The serum calcium was lower in cases as compared to the controls which was statistically significant (p<0.0001). A total of 71.66% of stroke patients had hyponatraemia, while ~48.33% of patients had hypocalcaemia.Conclusion: Dyselectrolytaemia is highly prevalent in stroke patients. Dyselectrolytaemia also varies with the type of stroke. Thus, serum electrolytes should be a part of the initial evaluation in all stroke patients to prevent morbidity and mortality.