Prognostic significance of serum globulin in patients with acute ischemic stroke

Qiao Han; Xiao Sun; Dongqin Chen; Huaping Du; Yaming Sun; Wanqing Zhai; Yongjun Cao; Shoujiang You; Huifeng Qian; Weidong Hu

doi:10.1016/j.jstrokecerebrovasdis.2023.107342

Prognostic significance of serum globulin in patients with acute ischemic stroke

J Stroke Cerebrovasc Dis. 2023 Nov;32(11):107342. doi: 10.1016/j.jstrokecerebrovasdis.2023.107342. Epub 2023 Sep 8.

Authors

Qiao Han¹, Xiao Sun², Dongqin Chen², Huaping Du³, Yaming Sun⁴, Wanqing Zhai⁵, Yongjun Cao⁶, Shoujiang You², Huifeng Qian⁷, Weidong Hu²

Affiliations

¹ Department of Neurology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215009, China.
² Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
³ Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou 215000, China.
⁴ Department of Neurology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, China.
⁵ Department of Neurology, The First People's Hospital of Taicang, Suzhou 215400, China.
⁶ Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Institutes of Neuroscience, Soochow University, Suzhou 215123, China.
⁷ Department of Neurology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215009, China. Electronic address: uucksqhf@163.com.

PMID: 37689030
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107342

Abstract

Background and purpose: We investigated the association between serum globulin levels upon hospital admission and in-hospital short-term outcomes in acute ischemic stroke (AIS) patients.

Methods: A total of 3,127 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included in the present study. We divided patients into 4 groups according to their level of admission serum globulin: Q1 (<23.5 g/L), Q2 (23.5-26.4 g/L), Q3 (26.4-29.9 g/L), and Q4 (≥29.9 g/L). Logistic regression models were used to estimate the effect of serum globulin on the short-term outcomes, including all cause in-hospital mortality, poor outcome upon discharge (modified Rankin Scale score ≥3) and in-hospital pneumonia in AIS patients.

Results: The median National Institutes of Health Stroke Scale (NIHSS) score was 4.0 (IQR, 2.0-7.0). The risk of in-hospital mortality was significantly higher in patients with highest serum globulin level (Q4) compared to those with lowest (Q1) (adjusted odds ratio [OR] 2.30; 95% confidence interval [CI], 1.12-4.70; P-trend =0.026). The highest serum globulin level (Q4) was associated with a 1.32-fold and 1.62-fold increase in the risk of poor outcome upon discharge (adjusted OR 1.32; 95% CI, 1.00-1.75; P-trend = 0.070) and in-hospital pneumonia (adjusted OR 1.62; 95% CI, 1.18-2.23; P-trend = 0.001) in comparison to Q1 after adjustment for potential covariates.

Conclusions: A high level of serum globulin upon hospital admission was independently associated with all cause in-hospital mortality, poor outcome upon discharge and in-hospital pneumonia in relative mild AIS patients.

Keywords: Acute ischemic stroke; In-hospital outcomes; Pneumonia, Predict; Serum globulin.