Available online at www.medicinescience.org ORIGINAL RESEARCH Medicine Science 2018;7(4):736-44 Validity and prognostic value of serum albumin level in emergency acute ischemic stroke egyptian patients Adel Hamed Elbaih, Islam M Elshaboury, Rasha M Ahmed, Monira A Abd Allah Suez Canal University, Faculty of Medicine Department of Emergency Medicine, Egypt Received 05 January 2018; Accepted 04 April 2018 Available online 20.09.2018 with doi:10.5455/medscience.2018.07.8844 Copyright © 2018 by authors and Medicine Science Publishing Inc. Abstract There are two main types of stroke: ischemic and hemorrhagic. Some studies showed the favorable relationship of serum albumin levels on the outcome of patients who sufer from ischemic stroke (IS). Some experimental studies have suggested a neuroprotective efect of albumin either by reducing brain edema or by its antioxidative or antiapoptotic efects. To detect serum albumin level and evaluate its prognostic value in patients with acute ischemic stroke in emergency department in compared to Scandinavian Stroke Scale (SSS). The study was carried out as descriptive (cross-sectional) study conducted on 60 patients with ischemic stroke attending emergency department in Suez Canal University hospital. It was found that all of died patients (100%) had hypoalbuminemia. While (92.5%) of patients who discharged from hospital had normal serum albumin level in follow up. but (7.5%) of them had hypoalbuminemia. And the ROC curve of both SSS and Serum albumin level on admission had Sensitivity: 100% and Specifcity: 83% among studied patients. Thus serum albumin level has a direct correlation with short term prognosis of acute ischemic stroke patients. Patients with a lower SSS on admission and had higher levels of serum albumin had good short-term prognosis, and those with a high SSS and had a lower level of albumin had bad prognosis. higher levels of serum albumin is associated with a better short term prognosis. So they may act as indicators of short term prognosis. Keywords: Ischemic stroke IS, scandinavian stroke scale (SSS), serum albumin, outcome Medicine Science International Medical Journal 736 Introduction A stroke or cerebrovascular insult is known as acute onset of a neurologic defcit that is due to a local vascular cause. The defnition of stroke is clinical and neuroimaging of the brain are used to confrm the diagnosis [1]. There are two main types of stroke: ischemic due to decrease of blood supply to brain and hemorrhagic due to bleeding. This result in part of the brain does not work properly. Stroke Signs and symptoms may include motor and sensory defcits of one side of the body, confusion, dysarthria, vertigo, or loss of vision. Hemorrhagic strokes as well can be associated with a severe headache [2]. This signs and symptoms might appear early after the stroke has occurred. If symptoms last less than one or two hours it is known as a transient ischemic attack (TIA).(5) Diagnosis is clinically and confrmed by computerized axial tomography (CT) or magnetic resonance imaging (MRI) commonly [3]. In 2013, after coronary artery disease stroke was considered to be *Coresponding Author: Adel Hamed Elbaih, Suez Canal University, Faculty of Medicine of Emergency Medicine, Egypt. E-mail: elbaihzico@yahoo.com the second most frequent cause of death worldwide, representing about 6.4 million deaths (12% of the total). About 17 million people had a stroke in 2010 and 33 million people have previously had a stroke and were still alive. Between 1990 and 2010 the number of strokes decreased by approximately 10% in the developed world and increased by 10% in the developing world [3]. An ischemic stroke, if diagnosed in about three to four and half hours, could be treatable with a medication which can break down the clot. Aspirin should be used. Stroke rehabilitation is the treatment which try recover lost function and ideally occurs in a stroke unit; however, these units are not available in many countries of the world [4]. The stroke severity on neurologic examination is typically the most important factor that afect short- and long-term outcome [5]. The Scandinavian Stroke Scale (Table 1) assesses the function of nine neurological states by using a scale of 0-6, where 0 represents severe malfunction and 6 represents full functionality. The scale’s minimum score is ‘0’ and the maximum ‘58’. The nine of the score items include: the Consciousness level, Movement of the eye, Motor power of arm, hand, leg (each assessed only on the afected side), Orientation, Speech, Facial palsy and Gait). Total scores can be used to stratify patients into four categories of stroke severity (Table 2) [6].