RESUMEN
Stress hyperglycaemia is a common problem in stroke population. Hyponatremia hypernatremia was reported In 25% and hypohalemia/ hyperhalemia in 27% of patients with acute ischemic and haemorrhagic stroke. The aim of this work was to assess the serum glucose, potassium and sodium levels in patients with acute cerebrovascular stroke and its relationship to the type of stroke, severity and prognosis. Fifty patients with acute cerebrovascular stroke [CVS] were randomly allocated and after CT scan of the brain, they were classified into: Group 1:25 patients with haemorrhagic stroke, Group 11:25 patients with ischemic stroke. All the patients were subjected to standardized clinical assessment, Glasgow coma scale [GCS] and Barthel Index [BI] at time of admission and after one week. Fasting blood sugar, Glycosylated hemoglobin [HbA Ic], serum potassium and sodium were measured at base line. Stress hyperglycemia was detected in 13[76%] of haemorrhagic stroke patients versus 4[24%] of ischemic stroke patients with statistical significant difference, p< 0.05. Hyponatremia was detected in 19[38%] of all stroke cases [11[22%] in haemorrhagic and 8[16%] in ischemic group]. No recorded cases with hypernatremia. Hypokalemia was detected in 4[8%] of all stroke patients [2 in each group]. Hyperkalemia was present in 14[28%] of all stroke patients [8]16%] in haemorrhagic and 6[12%] in ischemic group. There was statistical significant difference within each group as regard GCS1, GCS2, BI1, BI2 between patients with and without stress hyperglycemia and electrolyte disturbance, p<0.05. There was statistical significant difference in mortality rate between patients with and without stress hyperglycemia and electrolyte disturbance, p<0.05. Baseline hyperglycemia and electrolytes disturbances [hyponatremia, hyperkalemia and hypokalemia] are important prognostic factors related to outcome in stroke patients. Haemorrhagic stroke has more poor outcome than ischemic stroke which was related to male gender, smoking, higher BP, more frequent hyperglycemia and electrolytes disturbances. Lastly Ell < 60, GCSl< 8, hyperglycemia > 126, hyperkalemia and hyponatremia are independent predictors of poor outcome in stroke patients