Adel Mabrook AlSefari MD¹, Omar Khaled Ameen MD², Hanan AlHazmi MBBS MD¹, Ali Mahmoud AlBalawi MD², Fahmi AlSenani MBBS², Jamal Muthana MD², Mohammed Ahmed Melibari MD¹ and Manhal N Redwan MD¹

¹Diabetic and Endocrine Center, AlNoor Specialist hospital, Makkah, Kingdom of Saudi Arabia
²Stroke Program, Neurology Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia

*Corresponding Author: Omar Khaled Ameen, Stroke Program, Neurology Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.

Received: November 13, 2023; Published: December 12, 2023

Abstract

Background: Hypothyroidism can cause hypertension, hypercholesterolemia, cardiac dysfunction, and both hypo- and hypercoagulability; all of which are risk factors for stroke.

Objectives: To explore the association between thyroid disease and occlusion of large vessels as well as functional outcome in patients with ischemic stroke.

Material and Methods: A retrospective study was conducted among all acute ischemic stroke patients, secondary to large vessel occlusion, admitted to King Fahad Medical City (KFMC), Riyadh, Kingdom of Saudi Arabia, provided that thyroid hormones were measured for those patients. The electronic charts of all eligible patients admitted between January 2021 and June 2022 were reviewed. Severity of stroke was measured through the National Institute of Heath Stroke scale (NIHSS). Functional disability one month after discharge was assessed using the modified Rankin scale (mRS). Levels of thyroid hormones (thyroxine “T4”, Triiodothyronine “T3” and thyroid stimulating hormone “TSH”), low density lipoprotein (LDL) as well as glycated hemoglobin (HbA1c) were extracted from patients` electronic files.

Results: A total of 177 patients included in the study. Their age ranged between 17 and 100 years (60.74 ± 15.55). Males represented 56.3% of patients. Almost half (47.1%) of cases were categorized as severe stroke while 39.1% were mild to moderate. None of the studied patients` characteristics (age, gender, TSH, T3, T4, LDL, HbA1c) was significantly associated with stroke severity. Concerning functional disability one month after discharge, moderately severe and severe disabilities were observed among 27.7% and 21.5% of patients, respectively whereas death was reported in 15.8% of cases. Patients` age was highest in patients of category 5 (severe disability) (69.0 ± 14.6 years) and lowest among those of category 0 (no disability), p = 0.001. LDL level was highest among patients of category 2 (slight disability) and lowest among those of category 6 (dead) (3.2 ± 1.4 and 2.2 ± 1.1, respectively), p = 0.031. There was a statistically significant association between severity of stroke based on NIHSS scale and impact on functional outcome based on modified ranking scale, p<0.001.

Conclusion: Thyroid disorders were not associated with severity of stroke. Older patients had more severe functional disability while LDL was lowest among dead patients. Stroke severity was associated with functional disability.

Keywords: Stroke; Thyroid Diseases; Functional Disability

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Citation

Citation: Omar Khaled Ameen., et al. “Impact of Thyroid Disease on Functional Outcome in Ischemic Stroke Secondary to Large Vessel Occlusion". Acta Scientific Neurology 7.1 (2024): 15-21.

Copyright

Copyright: © 2024 Omar Khaled Ameen., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.