Can carboxyhemoglobin and total bilirubin be new prognostic indicators for determining mortality in ischemic stroke?
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Objective: The aim of this study is to determine the severity of inflammation induced by ischemic stroke via endogenous carbon monoxide and bilirubin levels. Design: Retrospective study Settings: The study was conducted in a tertiary care hospital serving as a stroke center. Subjects: The epicrises of 9,251 patients hospitalized in the emergency department to the neurology clinic and neurological intensive care were reviewed using the hospital automation system between 01.01.2010 and 31.12.2016. Of these patients, 1,644 with diffusional magnetic resonance images consistent with ischemia were included. Interventions: Non-interventional Main outcome measures: Carboxyhemoglobin and total bilirubin levels determining mortality in ischemic stroke patients Results: Males constituted 46.7% of the patients, and the mean age of the patients was 71.70 +/- 13.897 years. The mean carboxyhemoglobin, glucose and total bilirubin values were 1.6 +/- 1.0%, 149.61 +/- 69.2 mg/dL, and 0.69 +/- 0.55 mg/dL, respectively. Carboxyhemoglobin was not significant to determine in-hospital mortality after excluding smokers (p = 0.942). However, glucose and total bilirubin values were statistically significant in determining the rate of in-hospital mortality (p <0.05). Conclusion: We could not detect any effect of a high endogenous carbon monoxide level on mortality. The fact that the physiology of the brain differs from that of other organs and systems in the body limits the use of carbon monoxide as a prognostic marker in stroke patients.