EVALUATE THE CLINICAL PRESENTATIONS WITH S CALCIUM AS A BIOCHEMICAL PARAMETER IN PATIENTS ADMITTED WITH INTRACEREBRAL HAEMORRHAGE IN TERTIARY HOSPITALS IN BANGLADESH

Dr. Rajesh Saha*, Dr. Mohiuddin Ahmmed, Dr. Shekh Md. Abul Fazal and Dr. Rahat Amin Chowdhury

ABSTRACT

Background: In Bangladesh stroke has been ranked as the third leading cause of death after coronary heart disease and infectious diseases. The World Health Organization (WHO) ranks mortality due to stroke in Bangladesh as number 84 in the world. Spontaneous intracerebral haemorrhage (ICH) accounts for approximately 15% of all strokes and is a leading cause of disability, with a one-month mortality rate of 40%. Whereas factors predicting short-term mortality are well known, data regarding long-term outcome are scarce and imprecise. Aim of this study is to evaluate the clinical presentations with S calcium as A biochemical parameter in patients admitted with intracerebral haemorrhage in tertiary hospitals in Bangladesh. Methods: This study was a hospital based observational study and conducted at the Department of Neurology, Neurosurgery and Medicine in Dhaka Medical College Hospital. People who were suffering from intracerebral haemorrhage and were admitted in the department of Neurology, Neurosurgery and Medicine were approached for inclusion in the study according to inclusion and exclusion criteria. Ethical issues were ensured properly. After written informed consent history and physical examination were done. Diagnosis was confirmed by researcher with the aid of CT scan. Total 365 consecutive samples were collected and incompletion of data was considered exclusion of the study. Following radiological confirmation blood were drawn to measure serum calcium level with maintaining all aseptic precautions. For analysis patients‟ corrected serum calcium level were divided into three tertiles: T1 = <2.20 mmol/l, T2 = 2.20 to 2.40 mmol/l and T3 = >2.40 mmol/l. The principal investigator interviewed each patient individually and in case of unconscious patient; history was collected from attendant of the patient. All these were registered, documented and analyzed in the statistical program Statistical Package for Social Science (SPSS) version 20.0. Results: Out of a total of 365 patients, Mean age of the population was 58.43(±12.33)SD (range 32-75) years and frequent age group was 61-70 (n=145, 39.7%) years. 58% (n=210) were male and 42% (n=155) were female. Univariate analysis comparing the highest and lowest tertiles indicated that an elevated calcium level was associated with 5.1- and 3.1-fold increases in the odds for day 14- and 30-days excellent outcome, respectively. After adjustment for age, sex, and other potential risk factors, patients in the highest quartile still had significantly increased odds of day 14- and 30-day excellent outcome; the corresponding odds ratios (ORs) were 4.6 (95% confidence interval [CI], (2.41 – 8.93) and 3.31 (95% CI, 1.88 – 5.83). Conclusion: In conclusion we can say that Intracerebral Hemorrhage Patients also revealed positive association of outcome with serum calcium level and negative correlation with phosphate level.

Keywords: Serum calcium, Spontaneous intracerebral haemorrhage, ischaemic stroke.