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Subject Area

Neuropsychiatry

Article Type

Original Study

Abstract

Objective This work aimed to assess the risk of von Willebrand factor (vWF) in ischemic stroke (IS) among cirrhotic versus noncirrhotic patients and its relation to IS severity and outcome. Background Liver cirrhosis is complicated by extensive hemostatic dysfunctions. vWF is found to be elevated and may expose these patients to thrombosis. Therefore, cirrhosis may be associated with bleeding or thrombotic events. Patients and methods This study included 22 cirrhotic patients without IS, 18 noncirrhotic patients with IS, 33 cirrhotic patients with IS (mixed group), and 20 healthy control. They were subjected to vWF measurement by ELISA, imaging (abdominal ultrasonography, computed tomography, and/or MRI brain, echocardiography, and duplex Doppler ultrasound on carotid arteries), National Institute of Health Stroke Scale (NIHSS), and modified Rankin Scale (MRS). Results Serum vWF levels were highly significantly increased in IS (94.6 ± 6.3) and mixed groups (115.9 ± 42.1) compared with other groups (P < 0.001). vWF was statistically significant in correlation with NIHSS and Child's score (P = 0.016 and 0.041, respectively). There was no significant correlation between Child's score and NIHSS (P = 0.558) or MRS (P = 0.526) or between vWF and MRS (P = 0.194), IS subtypes, or outcome (P > 0.05). Longer hospital stay was reported in mixed (14.8 ± 3.3) compared with IS group (8.5 ± 1.7) (P < 0.001). Mixed group encountered a higher morbidity and mortality (44.4 and 22.22%, respectively) than IS group (51.5 and 24.24%, respectively), though was nonsignificant. Hypertension was the only highly significant risk factor for stroke among IS group. Conclusion Serum vWF was higher in cirrhosis and mixed groups than in IS, but had no role in increased morbidity and mortality in all groups. There was no significant correlation between the severity of liver cirrhosis and the severity of IS.

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