Physiological Aspects of Plasma Osmolarity and its Association with the Clinical Severity of Ischemic Stroke Evaluated with the NIHSS: A Cross-sectional Study

BACKGROUND: Ischemic stroke is one of the leading causes of mortality and disability worldwide. Recent studies have observed that some physiological factors play a pivotal role in determining stroke severity, which can be assessed using the National Institutes of Health Stroke Scale (NIHSS) score. Hydration status is one of the most frequently studied physiological factors and can be evaluated by measuring plasma osmolarity levels. However, studies regarding the association between plasma osmolarity and stroke severity remain scarce. AIM: This study aimed to investigate the association between increased blood plasma osmolarity levels and the NIHSS scores in patients with acute ischemic stroke. METHODS: This cross-sectional study obtained medical records of subjects aged 18–80 years old who were diagnosed with their first acute ischemic stroke from January to March 2021 at the Siloam Hospitals Lippo Village Tangerang in Indonesia. RESULTS: The NIHSS scores of patients with acute ischemic stroke were observed to have a moderate positive correlation with plasma osmolarity (p = 0.004, r = 0.309). Patients with an elevated plasma osmolarity had higher NIHSS scores than those with normal levels of plasma osmolarity (8.52 ± 5.01 vs. 6.03 ± 3.72). CONCLUSIONS: Higher levels of plasma osmolarity among acute ischemic stroke subjects correlated positively with increased NIHSS scores on admission.