Low Adjusted Serum Calcium Level as a Predictor of Poor Outcome in Patient With Acute Ischemic Stroke

Abstract: Calcium plays an important role in the pathogenesis of ischemic cell damage. Intracellular calcium accumulation leads to neuronal damage by triggering the cycle of cytotoxic events, however the relationship of Adjusted serum calcium levels and the pathways involved in ischemic injury is unclear. The aim of this study is to determine whether low Adjusted serum calcium levels can be used as predictor of poor outcome in acute ischemic stroke patient. This is a prospective cohort study of acute ischemic stroke patients admitted to Sanglah General Hospital from December 2016 until February 2017. Adjusted serum calcium level was obtained ?72 hours from onset. Outcome was classified as poor and good, according to the National Institutes of Health Stroke Scale (NIHSS) score taken on admission and 7 days after the onset. Statistical analysis was performed using using Chi-Square. A total of 60 patients were enrolled and met the criteria. Subject’s characteristic described by sex, age, onset, stroke type, serum adjusted calcium level, first and second NIHSS score. Serum adjusted calcium level mean was lower in poor outcome group (8,78 ± 0,07) than subjects in the good outcome (9,05 ± 0,06). Chi-square analysis revealed lower Adjusted serum calcium levels accompanied by poor outcomes statistically significant (RR = 3.2; 95% CI = 1.34 to 7.62; p = 0.007). Multivariate analysis revealed lower Adjusted serum calcium levels as an independent predictor of poor outcome in acute ischemic stroke (RR = 6.47; 95%IC = 1.69 to 24.72; p = 0.006). Low Adjusted serum calcium level is an independent predictor of poor outcomes in patients with acute ischemic stroke.