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

INTRODUCTION: Calcium plays an important role in the pathogenesis of ischemic cell damage. Intracellular calcium accumulation leads to neuronal damage by triggering the cycle of cytotoxic events. In this study, the association of serum calcium levels with clinical severity of ischemic stroke as defined by the National Institute of Health Stroke Scale (NIHSS) score was evaluated. MATERIALS AND METHODS: After obtaining ethical approval from the institutional ethics committee, data was collected from 60 ischemic stroke patients, who were divided into two groups of 30 patients each: group 1 with serum ionized calcium less than 4.5 mg/dl and group 2 with serum ionized calcium levels more than 4.5 mg/dl. The stroke severity in the two groups was assessed using the NIHSS score. RESULTS: The severity of ischemic stroke according to the NIHSS score was greater in patients with low serum ionized calcium levels compared to the severity of ischemic stroke in patients with normal serum ionized calcium levels. CONCLUSION: Serum ionized calcium certainly plays a role in the pathogenesis of ischemic stroke by influencing the cycle of cytotoxic events that result in ischemic cell death. This study showed that the severity of ischemic stroke was greater in patients with low serum ionized calcium levels compared to patients with normal serum ionized calcium levels.