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The effect of changes in homeostatic constants of blood parameters in patients with cardioembolic stroke on the clinical course and prognosis of the disease

Year: 2020, volume 16 Issue: №1 Pages: 384-388
Heading: Neurology Article type: Original article
Authors: Khakhanova O.N., Skorokhodov А.Р., Kutashov V.A., Ulyanova O.V.
Organization: Federal State Institution "416 Military Hospital", Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to assess the effect of changes in homeostatic constants of blood parameters in patients with cardioembolic stroke (CEI) on the clinical course and prognosis of the disease. Material and Methods. 90 patients were treated and examined in the acute period of CEI: 60 patients were discharged (main group) and 30 died (control group). A detailed study was made: general blood count, hemostasis, and biochemical changes in the blood. Neurological deficit was evaluated according to the NIHSS, Rivermead, and Rankin scales. Results. All homeostatic blood constants are higher than normal in patients who died compared to survivors (p <0.05). In patients with mortality on the first day, changes in blood biochemical parameters are more pronounced than in patients who died at a later date. The most pronounced changes in the biochemical analysis of blood (glucose, urea, creatinine, AsAT, AIAT), acid-base imbalance are associated with severe clinical manifestations of CEI and a high probability of death. The diabetes mellitus in patients with CEI is a kind of pathognomonic sign, marker and predictor of adverse outcome. Metabolic acidosis prevailed in the group of deceased patients, and respiratory acidosis prevailed in the group of survivors. Conclusion. Marked changes in homeostatic blood constants and pronounced neurological deficit at the time of the development of the disease are associated with severe clinical manifestations of CEI and a high probability of death.

Keywords: acid-base balance, cardioembolic stroke, laboratory blood parameters, neuroimaging changes in the brain

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All articles of the authors: Khakhanova O.N. , Kutashov V.A. , Skorokhodov A.P. , Ulyanova O.V.

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