Hubungan Dehidrasi dan Kadar Fibrinogen dengan Early Neurological Deterioration pada Stroke Akut

Abstract

Background: Early Neurological Deterioration (END) is a worsening of symptoms within hours or days after acute stroke and is associated with worse clinical outcomes. Dehydration is a condition that is often observed in acute stroke patients as a predictor of END. Apart from dehydration, another predictor of END in stroke is fibrinogen which plays an important role in the coagulation system and as a marker of systemic inflammation. Objective: To determine the association between dehydration and fibrinogen levels with Early Neurological Deterioration in acute stroke. Methods: This analytical study with a cross-sectional design was conducted in the H. Adam Malik General Hospital, Medan from April – October 2023. The research subjects were acute stroke patients who met the inclusion and exclusion criteria. The Blood Urea Nitrogen Creatine ratio (BUN/Cr) and Urine Specific Gravity were measured to assess dehydration, fibrinogen levels and the NIHSS score to assess END. The association between dehydration and END and the relationship between fibrinogen levels and END were analyzed using correlation coefficient contingency test. Results: A total of 60 subjects were obtained in this study with a mean age of 60,52 ± 13,30 years. There was a significant association between dehydration and END in acute ischemic stroke (p = 0,001, r = 0,510), as well as a significant association between fibrinogen levels and END in acute ischemic stroke (p = 0,018, r = 0,396). However, there was no significant association between dehydration and END in acute hemorrhagic stroke (p = 0,88), nor fibrinogen levels with END in acute hemorrhagic stroke (p = 0,592). Conclusion: There is a significant association between dehydration and fibrinogen levels with END in acute ischemic stroke. There is no significant association between dehydration and fibrinogen levels with END in acute hemorrhagic stroke.