Serum C-Reactive Protein and Admission Hyperglycemia as Predictors of Stroke Severity and Early Outcomes in Acute Ischemic Stroke: A Prospective Observational Study

Abstract

Background: Acute ischemic stroke (AIS) is a major cause of mortality and long-term disability worldwide, with a rapidly increasing burden in developing countries including India. Inflammation and stress-induced hyperglycemia play a crucial role in determining stroke severity and early outcomes. This study evaluated the correlation between serum C-reactive protein (CRP), admission random blood glucose (RBG), and neurological severity in patients with acute ischemic stroke (AIS). Methods: This prospective observational study included 100 adult patients with imaging-confirmed acute ischemic stroke admitted within 72 hours of symptom onset. Serum C-reactive protein (CRP) and random blood glucose (RBG) were measured at admission, and CRP was repeated on day seven. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) at admission and day seven. Clinical outcomes during hospitalization were categorized as stable or unstable based on changes in NIHSS score. Statistical analysis included correlation and significance testing, with p < 0.05 considered statistically significant. Results: The mean age of participants was 56.7 ± 14.3 years. Seventy-nine patients (79%) were male and 21 patients (21%) were female. Serum CRP levels demonstrated a strong positive correlation with NIHSS scores at admission and day seven (p < 0.001). Admission random blood sugar (RBG) levels were significantly higher among patients with moderate-to-severe and severe stroke compared to those with minor stroke (p < 0.001). Patients with unstable outcomes (13 patients, 13%) had significantly higher CRP levels compared to those with stable outcomes (87 patients, 87%) (p = 0.003). Persistent elevation of CRP on day seven correlated strongly with poorer neurological recovery (r = 0.780, p < 0.001). Conclusions: Serum CRP and admission are significant predictors of stroke severity and short-term outcomes in acute ischemic stroke. Early assessment of these biomarkers may aid in risk stratification and prognostication.