Correlation of serum cortisol levels with the severity of acute ischemic stroke

• Author Details:   
• Likhit Bulley
• Ajit Tambolkar
• Deepak Sadashiv Phalgune ^*
• Vihita Kulkarni
• Arun Bahulikar

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Background: There is an enormous requirement to identify a biomarker for forecasting the consequences of acute stroke. The studies finding the correlation between serum cortisol levels and the severity of acute ischemic stroke (AIS) are limited in the Indian population.
Aims & Objective: The current research was conducted to determine the correlation of serum cortisol levels with the severity of AIS.
Materials and Methods: One hundred and twenty patients of AIS confirmed on magnetic resonance imaging, admitted within 24 h of the symptoms, were included in this prospective observational study. The National Institute of Health Stroke Scale (NIHSS) score was noted within 24 h of onset, and the Modified Rankin's scale (mRS) was evaluated on the fifth day and 2-3 months after the onset. The primary outcome measures were the severity of AIS using the NIHSS scale and neurological functional outcome of AIS at the end of 5 days and after 2-3 months using mRS.
Results: A statistically significant positive correlation was observed between the serum cortisol levels with the NIHSS score (r = 0.898) and mRS score at day 5 (r = 0.875) and 2-3-month follow-up (r = 0.782). A statistically significant positive correlation was observed between the serum cortisol levels and the infarct size, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and random blood sugar levels.
Conclusion: The serum cortisol at baseline can be used as a marker of the severity measured by NIHSS and short and long-term prognosis measured by mRS after AIS.

Keywords: Acute ischemic stroke, Correlation, Modified rankin's scale, National institute of health stroke scale, Serum cortisol