Prognostic Value of Cortisol in Patients with Acute Ischemic Stroke

Background: Activation of the hypothalamo-pituitary-adrenal axis has been shown in acute ischemic stroke. Some recent studies suggest that serum cortisol level may have prognostic value in patients with ischemic stroke. The aim of this study was to evaluate the prognostic value of cortisol in patients with acute ischemic stroke. Methods: In this prospective observational study, 51 patients with acute ischemic stroke were evaluated. Cardioembolic and lacunar strokes were excluded. In the first 24 hours of admission, serum cortisol level, national institutes of health stroke scale (NIHSS), diabetes and hypertension were assessed to determine their value to predict mortality within 90 days. The results were analyzed using descriptive statistics, t-test, chi-square test and logistic regression. Results: In this study, 26 patients (51%) were female and the rest were male. Serum cortisol level was normal in 37 patients (72.5%). 14 patients died (27.5%) during the follow-up period. The mean serum cortisol level of dead patients were 33.48 ± 15.14 µg/dL and for alive patients was 35.10 ± 19.74. This difference was not statistically significant. After statistical analysis using logistic regression, no significant correlation between serum cortisol level and mortality was seen. Conclusions: Although ischemic stroke is associated with change in serum cortisol level but this change has no prognostic value.