Correlation of Serum Calcium with the Severity of Acute Ischemic Stroke Patients Presenting at Tertiary Care Hospital, Karachi
Serum Calcium with the Severity of Acute Ischemic Stroke Patients
DOI:
https://doi.org/10.54393/tt.v6i3.281Keywords:
NIHS Severity, High Blood Pressure, Type 2 Diabetes, Ischemic Stroke, Acute Stroke, Serum CalciumAbstract
Stroke is a significant chronic illness, death and disability in both developed and developing nations. The interrelation between the level of serum calcium and the processes of ischemic injury is not clear. Objectives: To identify the relationship between the level of serum calcium and the extent of acute ischemic stroke behavior in patients who reported to a tertiary care hospital in Karachi. Methods: The cross-sectional analytic study was done in the Neurology Department of Civil Hospital, Karachi. A total of 138 patients diagnosed with acute ischemic stroke, fulfilling the diagnostic criteria, were included after obtaining verbal consent. Serum calcium levels were measured within 24 hours of admission. Simple descriptive statistics (mean ± SD) were used for quantitative data, while qualitative variables were given in terms of frequencies and percentages. A p-value of less than 0.05 was taken as statistically significant. Results: Among 138 patients, the mean age was 51.14 ± 4.49 years, and the mean calcium level was 10.7 ± 1.32 mg/dl. Based on calcium quartiles, 28 (20.3%), 35 (25.4%), 54 (39.1%), and 21 (15.2%) patients fell into quartiles 1, 2, 3, and 4, respectively. Stroke severity (based on NIHSS scores) distribution was: mild (15.2%), moderate (29.7%), moderate to severe (20.3%), and severe (34.8%). Higher calcium levels were positively correlated with increased stroke severity (p≤0.05). Conclusions: Serum calcium levels measured within 24–48 hours of admission showed a strong correlation with both stroke severity and functional outcome. Therefore, calcium levels may serve as an indicator of disease severity in acute ischemic stroke patients.
References
Nayak RR and Narayanaswamy S. Association of Serum Calcium Levels with Infarct Volume and Stroke Scores in Acute Ischemic Stroke Patients: An Observational Study. Caspian Journal of Internal Medicine. 2022; 13(4): 780.
Khattak IQ, Fida M, Bibi R, Saleem A, Khan R, Afridi MU. Correlation of Serum Calcium with Acute Ischemic Stroke. Pakistan Journal of Medical and Health Sciences. 2023 Feb; 17(01): 190-. doi: 10.53350/pjmhs2023171190.
Ashraf AS, Hassan A, Saeed MH, Shamim A, Hammad H, Salim Y. Prevalence of Hypocalcemia in Patients with Acute Ischemic Stroke at A Tertiary Care Hospital. Pakistan Journal of Medical and Health Sciences. 2023 Oct; 17(04): 683-. doi: 10.53350/pjmhs2023174683.
Chang S, Zhang W, Wang M, Wang Z. Clinical Significance of MRA, TCD and Electroencephalogram in the Diagnosis of Intracranial Artery Stenosis in Ischemic Cerebrovascular Disease. Biotechnology and Genetic Engineering Reviews. 2024 Nov; 40(3): 2380-92. doi: 10.1080/02648725.2023.2199529.
Fatima N, Salman M, Husnain Hashim AA, Sayed TM, Waheed S. Prevalence of Newly Diagnosed Hypertension in Stroke Patients Presented to Tertiary Care Hospitals in Rawalpindi. Pakistan Journal of Medical and Health Sciences. 2022 Nov; 16(09): 826-. doi: 10.53350/pjmhs22169826.
Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide Stroke Incidence and Early Case Fatality Reported in 56 Population-Based Studies: A Systematic Review. The Lancet Neurology. 2009 Apr; 8(4): 355-69. doi: 10.1016/S1474-4422(09)70025-0.
Zhang Y, Zhang G, Chen X. Elevated Calcium After Acute Ischemic Stroke Predicts Severity and Prognosis. Molecular Neurobiology. 2024 Jan; 61(1): 266-75. doi: 10.1007/s12035-023-03581-8.
Mendelson SJ and Prabhakaran S. Diagnosis and Management of Transient Ischemic Attack and Acute Ischemic Stroke: A Review. Journal of the American Medical Association. 2021 Mar; 325(11): 1088-98. doi: 10.1001/jama.2020.26867.
Gupta A, Dubey U, Kumar A, Singh S. Correlation of Serum Calcium Levels with Severity and Functional Outcome in Acute Ischemic Stroke Patients. International Journal of Research in Medical Sciences. 2015 Dec; 3(12): 3698-702. doi: 10.18203/2320-6012.ijrms20151425.
Haider Z and Hussain SS. Prevalence of Ischemic and Hemorrhagic Stroke among Geriatric Patients Admitted in the Public Tertiary Care Hospitals of Peshawar. medRxiv. 2023 Apr: 2023-03. doi: 10.1101/2023.03.30.23287970.
Khandare P, Saluja A, Solanki RS, Singh R, Vani K, Garg D et al. Serum S100B and NSE Levels Correlate with Infarct Size and Bladder-Bowel Involvement among Acute Ischemic Stroke Patients. Journal of Neurosciences in Rural Practice. 2022 Mar; 13(2): 218. doi: 10.1055/s-0042-1743214.
Ashraf H, Ashfaq H, Dawood MH, Changez MI, Butt M, Ashraf A et al. Sex Disparities and Trends in Stroke Incidence, Prevalence, and Mortality in the US and Worldwide: Findings from the Global Burden of Disease, 1990–2021. Journal of Clinical Neuroscience. 2025 Mar; 133: 111029. doi: 10.1016/j.jocn.2025.111029.
Ishfaq M, Ullah F, Akbar S, Rahim F, Afridi AK. Correlation of Serum Calcium with Severity of Acute Ischemic Stroke. The Journal of the Pakistan Medical Association. 2017 Jan; 67(1): 20-3.
Ludhiadch A, Sharma R, Muriki A, Munshi A. Role of Calcium Homeostasis in Ischemic Stroke: A Review. Central Nervous System and Neurological Disorders-Drug Targets-CNS and Neurological Disorders). 2022 Jan 21(1): 52-61. doi: 10.2174/1871527320666210212141232.
GBD 2019 Stroke Collaborators. Global, Regional, and National Burden of Stroke and Its Risk Factors, 1990–2019: A Systematic Analysis for the Global Burden of Disease Study 2019. The Lancet. Neurology. 2021 Oct; 20(10) :795.
Li XY, Kong XM, Yang CH, Cheng ZF, Lv JJ, Guo H et al. Global, Regional, and National Burden of Ischemic Stroke, 1990–2021: An Analysis of Data from the Global Burden of Disease Study 2021. E-Clinical Medicine. 2024 Sep; 75. doi: 10.1016/j.eclinm.2024.102758
Allinson KS. Deaths Related to Stroke and Cerebrovascular Disease. Diagnostic Histopathology. 2025 Jan; 31(1): 22-31. doi: 10.1016/j.mpdhp.2024.10.005.
Werring D, Adams M, Benjamin L, Brown M, Chandratheva A, Cowley P et al. Stroke and Cerebrovascular Diseases. Neurology: A Queen Square Textbook. 2024 May: 107-98. doi: 10.1002/9781119715672.ch8.
Zhang Y, Zhang G, Chen X. Elevated Calcium After Acute Ischemic Stroke Predicts Severity and Prognosis. Molecular Neurobiology. 2024 Jan; 61(1): 266-75. doi: 10.1007/s12035-023-03581-8.
Prabhu SV, Tripathi BK, Agarwal Y, Kabi BC, Kumar R. Association of Serum Calcium Levels with Clinical Severity of Ischemic Stroke at the Time of Admission as Defined by NIHSS Score: A Cross-Sectional, Observational Study. Journal of Family Medicine and Primary Care. 2022 Oct 1; 11(10): 6427-32. doi: 10.4103/jfmpc.jfmpc_1033_22.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 THE THERAPIST (Journal of Therapies & Rehabilitation Sciences)

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are 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. For comments editor@thetherapist.com.pk