Abstract

Background and Purpose: Dyslipidemia is established risk factor for stroke. Previously published data suggests that higher cholesterol levels and lower HDL levels are associated with poor outcomes. This relationship has not been studied in Pakistani population. Our study aimed to determine effect of admission lipids on stroke severity and outcomes based on the mRS scores at admission and discharge, respectively, in our population.
Methods: Retrospective chart review of patients ≥ 17 years of age with stroke admitted to Shifa International Hospital in 2009 with IRB approval. Outcome and stroke severity were assessed using modified Rankin Scale (mRS) as the NIHSS score was not being calculated for all the patients admitted to the hospital in 2009.
Results: One hundred and sixteen patients were included. Seventy one (61.2%) were males (mean age - 64.4 ±13.7 years). Age and gender did not affect stroke severity and outcome. Cardioembolic strokes were associated with increased severity (p = 0.001); whereas hemorrhagic strokes were associated with poor outcomes (p = 0.029). High cholesterol levels at admission were significantly associated with stroke severity (p = 0.025). The discharge mRS was significantly worse with high admission cholesterol (p = 0.005). There was a significant relationship between high admission triglycerides and stroke severity (p = 0.003). High LDL at admission also significantly affected severity of stroke (p = 0.026). Low HDL levels showed a trend of severe strokes and worse outcomes but did not reach statistical significance.
Conclusion: Hypercholesterolemia is associated with high mRS score at the time of admission and discharge indicating a severe stroke and poor outcome respectively; whereas high triglycerides and high LDL are associated with high admission mRS scores indicating severe strokes. Low HDL may be associated with more severe strokes and worse outcomes in our population.

Key words: Stroke, dyslipidemia, Pakistan