Abstract Details

Title Differences in Admission Electrolyte Concentrations among Stroke Etiologies

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-035

Objective To explore whether admission potassium levels were different by stroke etiology, particularly stroke due to atrial fibrillation (AF) and cryptogenic stroke.

Background Diagnosis of cryptogenic stroke remains challenging. It is common practice for patients to be placed on cardiac monitoring to detect arrhythmias. Though abnormal electrolyte levels may predispose patients to arrhythmias, electrolyte are often not considered when risk-stratifying patients by stroke mechanism.

Design/Methods Retrospective analysis on 363 patients (mean age 63.3 years, 44% male) admitted with primary diagnosis of ischemic stroke to a comprehensive center from 8/1/13-7/31/14. Patients were classified by stroke etiology: AF, identified etiology other than AF, or cryptogenic. Admission potassium levels, co-morbidities, and demographics were collected. Analysis of variance (ANOVA) and chi-squared tests were used to compare characteristics by etiology. Significant variables from the univariate comparisons were included into a multivariable logistic regression to evaluate associations between potassium levels and stroke etiology.

Results In univariate analyses, mean potassium levels were significantly higher among those with identified stroke etiology other than AF (4.1mmol/L) as compared to AF (4.0) and cryptogenic stroke patients (3.9) (p=0.003). Age, sodium, chloride levels, hypertension, diabetes, and congestive heart failure were also found to significantly differ by stroke etiology (p<0.05) in univariate analysis. After adjustment for these covariates, potassium levels remained a significant predictor; increasing levels were associated with 59% lower odds of AF-related (95% CI: 24-78%) and 47% lower odds of cryptogenic stroke (95% CI: 12-68%) compared to a known other stroke etiology. A potassium > 3.7 had an 82% sensitivity and 76% probability of being an identified stroke etiology other than AF.

Conclusions Admission potassium levels were higher among patients with identified cause of stroke compared to stroke due to AF and cryptogenic stroke. Potassium levels may be considered when risk stratifying patients into stroke mechanism among cryptogenic patients with suspicion of underlying arrhythmia.

Authors/Disclosures
Rachel Forman, MD (Yale Neurology) PRESENTER	Dr. Forman has nothing to disclose.
Laurel J. Cherian, MD, FAAN (Rush University Medical Center)	The institution of Dr. Cherian has received research support from NIH.
James Conners, MD (Rush University Medical Center)	The institution of Dr. Conners has received research support from nih.
Rima Dafer, MD (Rush University Medical Center)	Dr. Dafer has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Dafer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Dafer has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Anderson, Rasor, and partners.
Nicholas D. Osteraas, MD (Rush University Med Center)	Dr. Osteraas has nothing to disclose.
Sarah Song, MD, MPH, FAAN (Rush University Medical Center)	Dr. Song has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN.
Alejandro Vargas, MD, MS, FAAN (Rush University Medical Center)	Dr. Vargas has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer U.S. LLC Pharmaceuticals.

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