The relationship between early neurological deterioration and serum albumin level in patients with acute ischemic stroke after intravenous thrombolysis

Abstract

Objective To illustrate the relationships between the serum albumin level and early neurological deterioration (END) after the intravenous thrombolysis in patients with acute cerebral infarction. Methods The clinical data were collected from 148 patients (within 4.5 h of onset) who received the intravenous thrombolytic therapy with alteplase from January 2017 to August 2018. According to the presence or absence of END, the patients were divided into deteriorating group and non-deteriorating group. The relationship among serum albumin level and END was analyzed by univariate and multivariate analysis. Results A total number of 148 patients were enrolled in this study, among whom 39 patients were in deterioration group and 109 patients were in the non-deterioration group. The total protein level, the albumin level and lymphocyte count were lower in deteriorating group as compared to those in the non-deteriorating group (P < 0.05), and the neutrophil count, red blood cell distribution width, international standardized ratio, fibrinase degradation products and National Institute of Health stroke scale (NIHSS) score at admission were higher in the deteriorating group (P < 0.05). Atrial fibrillation was more common in deteriorating group, and there were significance differences in the degree of stenosis and infarct location between the two groups (P < 0.05). Multivariate Logistic regression analysis showed that serum albumin level (OR=0.873, 95% CI 0.768-0.993), score at admission (OR=1.120, 95% CI 1.008-1.245), neutrophil count (OR=1.271, 95% CI 1.048-1.542), and the degree of cardiogenic stroke and responsible vessel stenosis may affect the short-term prognosis of acute ischemic stroke AIS after the intravenous thrombolysis. The Modified Rankin Scale (mRS) score (average 14 d) was negatively correlated with albumin level (r=-0.205, P=0.013). Conclusions Albumin level is a risk factor for END in patients with acute ischemic stroke. The albumin level of the deteriorating group is lower than that of the non-deteriorating group. The lower the albumin level,the higher the mRS score, the worse the prognosis. Key words: Intravenous thrombolysis; Albumin; Risk factors; Early neurological deterioration