Management Of Stroke Patients Research Articles

Analysis of Dominant Factors Affecting Pre-Hospital Stroke Management in Kupang City

The incidence of stroke is increasing every year, and effective management comprises both pre-hospital and hospital care. The key to successful management is for families to recognise the clinical symptoms and promptly seek medical attention. Delayed assistance frequently leads to complications, underscoring the importance of timely intervention to save lives and prevent long-term disabilities. The key to successful management is identifying a stroke and prompt transportation to a medical facility. This study used a quantitative approach with a cross-sectional design, and the total sample was 300 people, while data analysis was performed using the Chi-Square test and logistic regression. The results showed that the family decision-making time in taking a stroke patient to the hospital, individually or collectively, significantly affected the Accuracy of Pre-Hospital Stroke Patient Management with a value of P (Sig) < 0.05. The magnitude of the influence was indicated by the value of EXP (B), also known as ODDS RATIO (OR). Specifically, the Decision-Making Time by the family to take stroke patients to the hospital exhibited an OR of 20.714. This implied that respondents capable of making the right decision to take stroke patients to the hospital were 20.714 times more likely to be accurate in pre-hospital stroke patient management. Based on the results, it can be concluded that the dominant factor influencing pre-hospital stroke attack management is the family decision-making time to take the stroke patient to the hospital. Therefore, the Kupang City government needs to improve ambulance facilities for the public, making it easier to access services, specifically in emergencies.

Succesful Management of Ischemic Stroke Patients with Pneumonia, Diabetes Mellitus and Hypertension in the ICU

Background:Stroke is one of the main causes of death worldwide. Although neurological complications are the leading cause of death, half of acute stroke patients may die from other medical complications, including pulmonary infections.Case Presentation :It has been reported that a patient aged 65 years with ischemic stroke who was treated in the ICU accompanied by diabetes mellitus, acute kidney injury, and hypertension. During treatment in the ICU the patient experienced complications of pneumonia. The patient underwent endotracheal intubation and ventilator installation as well as a percutaneous dilatational tracheostomy (PDT). During treatment the patient received antibiotic therapy, blood sugar regulation with insulin, administration of antihypertensive drugs. The patient experienced clinical improvement and was discharged from the ICU after 18 days of treatment and was subsequently treated in the HCU.Conclussion:The length of stay of stroke patients in the ICU requires attention, especially with regard to the problem of nosocomial infections that may accompany the patient during the treatment. If there is infection or other complications, appropriate selection of antibiotics and supportive therapy is necessary during treatment.

Mechanical Thrombectomy via Transbrachial Approach in the Emergency Management of Acute Ischemic Stroke Patients with Aortic Pathologies: Our Experience and Literature Review.

Mechanical thrombectomy (MT) via the transbrachial approach (TBA) is a very rare option used in cases of patients with aortic pathologies and acute ischemic stroke (AIS) due to the insufficient evidence in the literature, the difficulty from a technical point of view and the result of this technique influenced by the complications that frequently accompany it. Only a few cases of patients with aortic pathologies and acute ischemic stroke where MT via TBA were reported in the literature, and its application in the emergency management of AIS has still not been dealt with in detail. Out of a need to clarify and clearly emphasize the effectiveness of this approach in emergency MT via TBA in patients with AIS and aortic pathologies, this literature review and case report has the following objectives: the first one is the presentation of an emergency MT via transbrachial approach performed in a 44-year-old patient with AIS and diagnosed aortic coarctation during transfemural approach (TFA), with successful reperfusion in our department and the second one is to review the cases reports of patients with different aortic pathologies and AIS reperfusion therapy performed by MT via TBA from the literature. A total of nine cases (one personal case and eight published cases) were revised in terms of aortic pathologies type, reperfusion therapy type, and the complication of both mechanical thrombectomy and local transbrachial approach. Mechanical thrombectomy through the transbrachial approach was the first choice in more than half of these cases (55.55%, n = 5 cases) in the treatment of acute ischemic stroke in the presence of previously diagnosed aortic pathologies. In one-third of all cases (33.33%, n = 3, our case and 2 case reports from the literature), the transbrachial approach was chosen after attempting to advance the guiding catheter through the transfemoral approach and intraprocedural diagnosis of aortic pathology. In only one case, after an ultrasound evaluation of the radial artery that showed a monophasic flow, MT was performed via TBA. Local transbrachial complication was reported in one case, and in two other cases, it was not stated if there were such complications. Hemorrhagic transformation of AIS was reported in two cases that underwent MT-only cerebral reperfusion via TBA, one with acute aortic dissection type A and our case of previously undiagnosed aortic coarctation. In the cases in whom short and long-term follow-up was reported, the outcome of treatment, which was not exclusively endovascular (77.77% cases with only MT and 33.33% with association of first thrombolysis and after MT), was good (six from nine patients). In two case reports, the outcomes were not stated, and one patient died after a long hospitalization in the intensive care unit from respiratory complications (our patient). Being a clinical emergency, acute ischemic stroke requires urgent medical intervention. In patients with aortic pathologies, where acute ischemic stroke emergency care is a challenge, mechanical thrombectomy via the transbrachial approach is a safe alternative method for cerebral reperfusion.

Alleviating sleep disturbances and modulating neuronal activity after ischemia: Evidence for the benefits of zolpidem in stroke recovery.

Sleep disorders are prevalent among stroke survivors and impede stroke recovery, yet they are still insufficiently considered in the management of stroke patients, and the mechanisms by which they occur remain unclear. There is evidence that boosting phasic GABA signaling with zolpidem during the repair phase improves stroke recovery by enhancing neural plasticity; however, as a non-benzodiazepine hypnotic, the effects of zolpidem on post-stroke sleep disorders remain unclear. Transient ischemic stroke in male rats was induced with a 30-minute middle cerebral artery occlusion. Zolpidem or vehicle was intraperitoneally delivered once daily from 2 to 7 days after the stroke, and the electroencephalogram and electromyogram were recorded simultaneously. At 24 h after ischemia, c-Fos immunostaining was used to assess the effect of transient ischemic stroke and acute zolpidem treatment on neuronal activity. In addition to the effects on reducing brain damage and mitigating behavioral deficits, repeated zolpidem treatment during the subacute phase of stroke quickly ameliorated circadian rhythm disruption, alleviated sleep fragmentation, and increased sleep depth in ischemic rats. Immunohistochemical staining showed that in contrast to robust activation in para-infarct and some remote areas by 24 h after the onset of focal ischemia, the activity of the ipsilateral suprachiasmatic nucleus, the biological rhythm center, was strongly suppressed. A single dose of zolpidem significantly upregulated c-Fos expression in the ipsilateral suprachiasmatic nucleus to levels comparable to the contralateral side. Stroke leads to suprachiasmatic nucleus dysfunction. Zolpidem restores suprachiasmatic nucleus activity and effectively alleviates post-stroke sleep disturbances, indicating its potential to promote stroke recovery.

Abstract NS7: Improving Emergency Department Hemorrhagic Stroke Management

Background and Issues: The Emergency Department lacked a formal hemorrhagic stroke process for the management and care of non-traumatic hemorrhagic patients which resulted in increased length of stay in the department and poor patient outcomes. Purpose: The purpose of this quality improvement project was to develop and implement a standard process of care for hemorrhagic stroke in our emergency department. Methods: This project was aimed at improving the overall emergency department management of hemorrhagic stroke patients by developing a standard process of care for this patient population. Project analysis began by identifying care opportunities. Our action plan was aimed at: developing a hemorrhagic stroke algorithm of care, implementing a hemorrhagic stroke paging process, implement best practice care for hemorrhagic stroke, develop a consulting services process, develop a power plan for hemorrhagic stroke, develop a data gathering method for tracking, and develop a hemorrhagic stroke feedback method. Results: Lessons learned from this project were that developing a standard process of care around this patient population led to better adherence to hemorrhagic stroke goals, management, and patient care. Conclusion: In conclusion, developing an emergency department hemorrhagic stroke process of care led to decreased length of stay in our emergency department, better adherence to hemorrhagic stroke goals, better management of blood pressure in this patient population, early recognition and awareness by caregivers and stroke team, and clearly defined consultation guidelines for streamlined patient care. Development of such a process raised the standard of care for this patient population and leads to overall improvement in patient management.

Abstract WP146: Critical Care After Thrombolytic Therapy in Acute Stroke: Who Really Needs the ICU?

Introduction: Intravenous thrombolytic therapy remains the cornerstone of management in acute ischemic stroke (AIS) patients. Given the potential adverse effects of thrombolysis, patients are admitted to an intensive care unit (ICU) for close monitoring following administration. Alternative post-thrombolytic pathways may provide for safe cost-effective care in certain populations. We aimed to determine the proportion of patients treated with thrombolytics who required ICU care for reasons other than frequent neurologic monitoring and define their characteristics. Methods: We retrospectively reviewed patients ≥ 18 years of age who received TNK/ tPA for AIS at our community-based stroke center between May 2020 and August 2022. Patients were classified as requiring ICU care if they required intubation within 24 hours of admission or neurosurgical intervention, had symptomatic hemorrhagic conversion or brain compression, required a continuous infusion for hemodynamic management, or were in status epilepticus. Univariate and multivariate statistical analysis was performed. The study protocol was deemed exempt by our institutional IRB. Results: 262 patients met inclusion criteria. 54 (20.6%) required ICU level of care. Characteristics of those requiring ICU level of care are described in Table 1. Multivariate analysis showed that patients on antiplatelet or anticoagulant therapies prior to arrival (AOR: 2.205, p= 0.021) or who presented with higher initial NIH stroke scale (AOR: 1.108, p < 0.001) had significantly higher likelihood of requiring ICU level of care. Conclusions: In our cohort, approximately 21% of patients required critical care. Anticoagulant or antiplatelet therapy prior to admission and greater NIH stroke scale on arrival were associated with an increased likelihood of requiring ICU level of care. Further prospective studies are indicated to assess the efficacy of alternative settings for post-thrombolytic care in selected AIS patients.

Enhancing Ischemic Stroke Management with Cluster Nursing: A Comparative Study on the Effects of Ginkgo biloba Diterpene Lipid Amine Treatment

This study aimed to investigate the effect of cluster nursing on the management of ischemic stroke patients receiving Ginkgo biloba diterpene lipid amine treatment. This study was conducted on 197 patients from the Neurology Department of the author’s hospital from December 2021 to December 2022. These patients were divided based on their admission time into two groups: a control group comprising 98 patients who received routine nursing care and an observation group of 99 patients who were administered cluster nursing. This study evaluated and compared the incidence of nutritional intolerance events, nursing-related adverse events, and the overall quality of life among these groups. Results indicated a statistically significant reduction in the incidence of nutritional intolerance (P < 0.05) and nursing adverse events associated with enteral nutrition support (P < 0.05) in the observation group compared to the control group. Furthermore, the observation group exhibited higher scores in family role, energy, and verbal ability (P < 0.05), suggesting an improvement in the quality of life. These findings highlight the effectiveness of the cluster nursing approach in improving the management and outcomes for ischemic stroke patients in terms of reducing nutritional intolerance and nursing adverse events, thereby significantly enhancing the quality of life.

Pemberdayaan Kader Dan Keluarga Untuk Mencegah Kejadian Jatuh Pada Lansia Pasca Stroke

Stroke is a disease caused by interruption of blood flow to the brain or blood flow to the brain stops. The impact of a stroke can cause disability and will affect daily activities. One of the physical problems caused by elderly stroke patients is falling. There is a risk of falling because sufferers experience disability, loss of sensation, decreased ability to coordinate the body, decreased muscle function which results in a decrease in the ability to support, hold and balance body mass, and difficulty in directing, measuring the speed of the ability of muscles to maintain body balance. Family support is something that needs to be considered in the management of stroke patients because it plays a very important role in patient adherence to undergoing rehabilitation to prevent re-stroke. The purpose of this community service activity is to empower families and cadres in an effort to prevent falls in the elderly after a stroke so as to reduce the number of falls. in the elderly in carrying out their daily activities. Strategy Activities are carried out by means of training using PPT, and videos for 2 days followed by mentoring for 4 weeks involving 6 cadres, 24 families with post-stroke elderly, so a total of 30 people. Results There is an increase in family knowledge and attitudes and skills in preventing post-stroke falls in the elderly

Acute Management of Stroke in Patients with Polycythemia Vera

Acute Management of Stroke in Patients with Polycythemia Vera

Posisi Head Up Dapat Meningkatkan Saturasi Oksigen Pada Pasien Stroke : Literature Review

Stroke is one of the most common diseases in society. One of the nursing management of critical stroke patients is head-up intervention. Objective: to identify whether the head-up position affects the increase in oxygen levels in stroke patients. Research Methods: This type of research is a Literature Review study. The research was conducted by entering the keywords Head Up Position, Oxygen Saturation, and Stroke in the database. Then articles were selected based on inclusion and exclusion criteria. The articles used are articles published in the last 5 years. Results: A number of eight articles said that the head-up position can increase oxygen saturation, whereas two articles said that head up had no effect on increasing oxygen saturation levels. Conclusion: Based on search results and article analysis, it was found that the concept of the head-up position can increase oxygen saturation in stroke patients and cannot be maintained. Suggestion: the concept of the head-up position can increase blood oxygen levels in stroke patients not to be maintained until there are further studies with stronger results

A few-shot learning-based ischemic stroke segmentation system using weighted MRI fusion

Stroke, particularly ischemic stroke, is a major cause of disability and one of the leading causes of adult mortality worldwide. Early and prompt management of stroke patients can reduce the severity of the disease. Doctors usually determine the severity of a stroke by focusing on the region of interest (ROI) in the MRI or CT scan images. An accurate and effective automatic image segmentation system can assist medical professionals as well as automatic detection and classification systems. Deep learning is the current advanced approach for dealing with machine learning and artificial intelligence. However, conventional deep learning requires a large amount of data for training, and the amount of labeled data in the medical field is limited. In this paper, we propose a few-shot learning strategy and integrate it with a base convolutional neural network model, which utilizes a self-attention mechanism to segment MRI for ischemic stroke. By combining the base model with self-attention, we can focus more on the ROI and disregard less important features. Additionally, the proposed system only selects slices with lesions and ignores unlesioned slices. This helps to improve efficiency and reduce the computational load by eliminating the need to tune unnecessary parameters. To achieve even better results, the system also combines two weighted images, FLAIR and DWI, as an early fusion process. Experiments have shown that this approach leads to higher performance compared to using the same system without fusion. The proposed system is evaluated using a publicly available dataset, ISLES 2015 SSIS, and compared with other state-of-the-art (SOTA) systems. It achieves a dice coefficient score of 0.68, which is significantly better than that of other SOTA systems.

Abstract 14130: Efficacy and Safety of Endovascular Therapy in Stroke Patients With Large Ischemic Core in Comparison to Medical Management: Meta-Analysis of Randomized Control Studies

Introduction: Endovascular therapy (EVT) is a treatment recommended for stroke patients with large vessel occlusion and an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) ≥6. However, the utility of EVT in patients with large core ischemic stroke has not been well established. Methods: This meta-analysis assesses EVT's efficacy and safety using available trials comparing EVT to medical management (MM) in stroke patients with large ischemic core. Eligibility criteria: 1) were randomized controlled trials, 2) compared EVT with MM alone, 3) studied patients presenting with LIC cerebrovascular events, and 4) reported outcomes of interest. We extracted data for the major imaging inclusion criteria, the National Institutes of Health Stroke Scale (NIHSS) score, pre-stroke mRs score, and occlusion site. We also extracted outcome data for the EVT groups vs MM groups, including measurement of early neurological recovery, and definition of sICH. Results: Our primary end point was the mean modified Rankin scale score (RSS) at 90-day follow up. EVT was associated with higher odds of significant improvement in functional status with reduction in mean mRS by -0.31 [-0.47; -0.14]) compared to MM. The odds of achieving mRS 0 to 2 was higher in the EVT arm compared to the MM arm (2.53 [1.59; 4.02]). There was no difference in achieving mRS 0 to 3, early neurologic improvement defined according to NIHSS score, overall 90-day mortality and risk of symptomatic ICH between patients treated with EVT or MM in our analysis. Conclusions: Our study suggests that EVT may lead to improved outcomes in stroke patients with large core ischemia.

Efficacy of scapular and upper limb proprioceptive neuromuscular facilitation techniques on scapular alignment, upper limb function, and gait in subacute stroke: a randomized controlled trial protocol

Background: Stroke is a neurological disability produced by vascular-related acute focal injury to the central nervous system and is one of the leading causes of disability in adults, and it is frequently accompanied by motor skill loss. Patients suffering from hemiplegia after a stroke are more prone to have fall and are more likely to experience further injury due to irregular gait, diminished muscular strength, and functional impairment. In the affected upper limb of the hemiplegic stroke, spasticity in the shoulder girdle causes scapular malalignment, which reduces the functional mobility and stability of the upper limb. This is reflected as the reduced reciprocal arm swing during walking, which is further reinforced by an abnormal synergy pattern on the affected side. Proprioceptive neuromuscular facilitation (PNF) is a treatment strategy that stimulates motor activity and enhances control and function of the neuromuscular system. This research protocol is intended to assess and evaluate the effects of applying scapular and upper limb PNF along with conventional physiotherapy treatment to subacute-stroke patients on their scapular alignment, upper limb function, and gait. Methods: A total of 40 individuals in total will be allocated equally into two groups, group-A (experimental) and group-B (control). Both groups will be receiving treatment for six weeks with five sessions per week. Each patient will be examined both before and after therapy using the Palpation Meter (PALM), the Fugl-Meyer Assessment of Upper Extremity (FMA-UE), 10-Meter Walk Test, Handheld dynamometer (10MWT), and Dynamic gait index (DGI). After six weeks of therapy, the results will be assessed and the data will be analyzed before and after the intervention using a paired t-test to discover within-group differences in measurements. Conclusions: This physiotherapy method may be used in the management of stroke patients if our study's hypothesis is found to be valid. Registration: CTRI (CTRI/2023/05/052930, 19/05/2023).

Patient sentiment regarding stroke: Analysis of 2,992 social media posts

IntroductionSocial media reflects personalized sentiment toward disease and increasingly impacts perceptions of treatment options. This study aims to assess patients experience with and perception of stroke through an analysis of social media posts. MethodsA variety of terms ("stroke", "stroke survivor", "stroke rehab", "stroke recovery") were used to search for possible qualified posts on Twitter and Instagram. Twitter posts containing "#stroke" and "@stroke" were identified, yielding 2,506 Twitter posts relating to the patient's own experience. Four hundred sixty-eight public Instagram posts marked under "#stroke" and "@stroke," including direct references to the patient's own experience, were analyzed. First vs. recurrent stroke was identified when possible. The posts were coded for themes relating to patient experience with the disease. ResultsThe most common Twitter theme was raising stroke awareness (23.4 %), while spreading positivity was the most common Instagram theme (66.7 %). Most Twitter posts (93.9 %) were from patients experiencing their first stroke, with only 6.1 % of the posts being about recurrent strokes. Women created the majority of Instagram (75.7 %) and Twitter (77.3 %) posts. Men were more likely to discuss mobility/functional outcomes (p = 0.001) and survival/death (p = 0.014), while women were more likely to recount symptoms (p = 0.014), depression (p = 0.002), fear (p<0.001), and mental health (p = 0.006). ConclusionStroke patients most often describe their quality of life and discuss raising awareness via social media. Men and women differ in the most commonly shared aspects of their stroke experience. Gauging social media sentiment may guide physicians toward better counseling and psychosocial management of stroke patients.

Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study

Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study

313 Audit of adherence to the National Standards of acute stroke metrics in a tertiary hospital in Dublin, Ireland

Abstract Background Acute stroke is a medical emergency defined as a sudden neurological event of vascular origin caused by decreased cerebral perfusion, preventing oxygen and nutrient supply to parts of the brain, leading to neuronal cell death. The annual cost for the management of stroke patients in Ireland is approximately €489–€805 million. Treatment of ischaemic stroke is very time-dependent and the two main therapies currently available, are intravenous thrombolysis with tissue plasminogen activator (tPA), and endovascular thrombectomy. The aim of this study is to assess the adherence to key performance parameters, but not limited to, such as the onset of symptoms to hospital arrival, time of hospital arrival to imaging, time of hospital arrival to tPA, and time of symptoms onset to recanalization in a tertiary stroke unit as compared to the 2021 Irish National Audit of Stroke report. Methods We carried out a retrospective chart review of 100 stroke patients admitted from 1st January 2022 until 31 December 2022 who were identified using The Hospital In-Patient Enquiry (HIPE). We accessed various hospital sources including PIPE, thrombectomy software, McKesson Radiology and medical charts to retrieve data of interest. This audit was registered with the Hospital Audit Office (CA 2023/112). Results We report here a thrombolysis rate of 18% with 75% receiving tPa within 1 hour of hospital arrival compared to 10% and 56% reported by INAS, respectively. The median door-to-image and door-to-needle for Beaumont Hospital were 24 mins and 42 mins compared to 63 mins and 43 mins reported by INAS, respectively. Conclusion Beaumont Hospital is compliant and performs higher compared to the national average. Inclusion of more study participants is needed to confirm the findings of this report.

Management of Stroke in Patients With Chronic Liver Disease: A Practical Review.

Chronic liver disease (CLD) is a highly prevalent condition. There is burgeoning recognition that there are many people with subclinical liver disease that may nonetheless be clinically significant. CLD has a variety of systemic aberrations relevant to stroke, including thrombocytopenia, coagulopathy, elevated liver enzymes, and altered drug metabolism. There is a growing body of literature on the intersection of CLD and stroke. Despite this, there have been few efforts to synthesize these data, and stroke guidelines provide scant guidance on this topic. To fill this gap, this multidisciplinary review provides a contemporary overview of CLD for the vascular neurologist while appraising data regarding the impact of CLD on stroke risk, mechanisms, and outcomes. Finally, the review addresses acute and chronic treatment considerations for patients with stroke-ischemic and hemorrhagic-and CLD.

Relevance of NIHSS subitems for best revascularization therapy in minor stroke patients with large vessel occlusion: an observational multicentric study.

The best management of acute ischemic stroke patients with a minor stroke and large vessel occlusion is still uncertain. Specific clinical and radiological data may help to select patients who benefit from Endovascular Therapy (EVT). We aimed to evaluate the relevance of NIHSS subitems for predicting potential benefit of EVT after intravenous thrombolysis (IVT)("bridging treatment") versus IVT alone. We extracted demographic, clinical, risk factor, radiological, revascularization and outcome data from consecutive patients with M1 or proximal M2 middle cerebral artery occlusion and admission NIHSS scores of 0-5 points treated with IVT+/-EVT between May 2005 and March 2021 from nine prospectively-constructed stroke registries from seven French and two Swiss comprehensive stroke centers. Adjusted interaction analyses were performed between admission NIHSS subitems and revascularization modality for two primary outcomes at 3 months: non-excellent functional outcome (mRS 2-6) and difference in NIHSS score between 3 months and admission RESULTS: Of the 533 patients included (median age 68.2 years, 46% women, median admission NIHSS score 3), 136 (25.5%) patients initially received bridging therapy and 397 (74.5%) IVT alone. Adjusted interaction analysis revealed that only facial palsy on admission was more frequently associated with excellent outcome in patients treated by IVT alone versus bridging therapy (OR=0.47, 95%CI=0.24-0.91, p=0.013). Regarding NIHSS-difference at 3 months, no single NIHSS subitems interacted with the type of revascularization. This retrospective multicenter analysis found that NIHSS subitems at admission had little value in predicting patients who might benefit from bridging therapy as opposed to IVT alone. Further research is needed to identify better markers for selecting EVT responders with minor strokes.

Stroke Systems of Care:: A Systematic Approach to Saving Neurons.

Stroke continues to be a major public health concern, accounting for more than 800,000 strokes per year and remains the leading cause of disability. Stroke systems of care are comprehensive frameworks designed to ensure efficient and effective management of stroke patients. This article provides a brief overview of the coordinated network of healthcare providers, emergency medical services, and hospitals working together to deliver timely and specialized care including pre-hospital care, acute hospital care, rehabilitation, and community reintegration.

Quantitative analysis of cell-free plasma DNA as a prognostic biomarker in acute ischemic stroke patients

BackgroundStroke has become a leading cause of death and disability worldwide, and despite the introduction of new screening programs, therapies, and monitoring technologies, there is still a need to develop more useful biochemical tests to monitor treatment response and inform clinical decision-making. Cell-free DNA released from damaged neurons in stroke patients may be useful in assessing stroke prognosis. The purpose of this study was to evaluate the role of cell-free DNA and a highly sensitive blood biomarker in acute ischemic stroke. 188 patients with acute ischemic stroke were recruited for the study. The level of cell-free DNA in plasma was estimated using a real-time PCR assay for the β-globin gene (Qiagen-Rotor-Gene Q MDX, Germany). Clinical assessment was performed with the National Institutes of Health Stroke Scale (NIHSS) at the time of admission. After a period of three months from the onset of stroke, (mRS) scores were estimated using the modified Rankin scale.ResultsElevated levels of cell-free DNA were found in patients with higher NIHSS admission scores and mRS 3-month scores (p < 0.05). The regression analysis revealed that the markers are associated with an unfavorable outcome in comparison to other stroke risk factors (R2 = 0.224). Stroke outcome was relatively better in patients with a cell-free DNA level < 10,000 kilogenome equivalents/L (p < 0.05).ConclusionsMeasurement of total cell-free DNA levels is a simpler and less-expensive biomarker suggesting potential clinical application of blood-based test. Cell-free DNA can contribute to the clinical evaluation and optimal management of ischemic stroke patients. This biomarker seems to have the potential to predict the long-term prognosis of acute ischemic stroke.