CRP in cerebrovascular stroke: Prognostic implications

BackgroundCerebrovascular stroke (CVS) is a common cause of death and disability. The C-reactive protein increases in response to stroke and may be used as a predictor for stroke outcome. We intended in this study to evaluate the role of serum CRP in predicting outcomes in CVS.MethodsWe included 50 patients with a first-ever acute stroke admitted within 24 h of onset with a mean age of 59.5 ± 8.6 years. Neurological evaluation of our patients on admission included assessment of stroke severity by the National Institute of Health Stroke Scale (NIHSS) while seven days later; outcome was evaluated by a modified Rankin Scale (mRS) and Barthel ADL index (BI). CRP level assay and CT brain were done to all patients on admission.ResultsIn the ischemic stroke group, we found that serum CRP level on admission was predictive of stroke severity (positively correlated with NIHSS (r = 0.54, P = 0.006)) as well as outcome (positively correlated with mRS (r = 0.56, P = 0.004) and negatively correlated with BI (r = −0.66, P < 0.001)). A CRP level of 10.25 mg/L was predictive of a severe ischemic stroke with a sensitivity of 80% and a specificity of 75% as well as a poor outcome using mRS with a sensitivity of 75% and a specificity of 82%. In hemorrhagic stroke, however, CRP level was not correlated with either disease severity or with the outcome scores.ConclusionWe concluded that the serum CRP level on admission can be used to predict severity and early outcome in ischemic but not in hemorrhagic stroke.