To determine the relationship between admission serum highly sensitive CRP(hsCRP) and the following:

1. 1. Severity of both acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH)
2. 2. Thirty-day case fatality rate(CFR) in both AIS and ICH
3. 3. Thirty-day functional outcome of survivors in both AIS and ICH

Acutely elevated CRP has been associated with outcome following stroke (particularly ischaemic stroke, less so with intracerebral haemorrhage).

This study recruited consecutively presenting first-ever strokes within 7 days of onset. Age and gender-matched healthy controls were also recruited.   Baseline demography, clinical parameters, admission NIHSS score, admission Glasgow Coma Scale (GCS), and ICH scores were documented. Cases were followed up till death or for 30 days whichever occurred first. Outcome was case fatality at 30 days post stroke and functional outcome in survivors using the modified Rankin scale.

107 AIS, 114 ICH, and 104 controls, were recruited. Mean age (years) of all strokes was 56.4±12.3.  HsCRP was higher in AIS (13.2±7.3) compared to ICH (10.7±3.8) (p=0.004). Strokes with elevated hsCRP had higher severity of stroke based on admission median GCS scores (11.5 v. 15, p=0.002), median admission NIHSS (in AIS) (13 v. 9, p=0.017) and median ICH score (1 v. 0, p=0.59). 30-day CFR was 19.0% (33/174) for stroke with elevated hsCRP, and 4.3% (2/47) for normal hsCRP (p=0.008). In AIS, CFR in elevated versus normal hsCRP was 13.8% (11/80) and 3.7% (1/27) (p=0.14). In ICH, CFR in elevated versus normal hsCRP was 23.4% (22/94) compared with 5.0% (1/20) (p=0.05). Functional outcome was poor in 69 cases (48.9%) of stroke with elevated hsCRP compared to 17 (37.8%) of those with normal CRP (p=0.13).

CFR was significantly higher in all strokes (overall) with elevated hsCRP. There was a non-significant trend of poorer functional outcome in the presence of elevated CRP overall and in both subtypes.