Ferritin Levels in Acute Ischaemic Stroke: Insights and Association with Stroke Severity by National Institutes of Health Stroke Scale and Functional Outcomes on the Modified Rankin Scale
Published: November 1, 2025 | DOI: https://doi.org/10.7860/JCDR/2025/81350.22051
Ronak Prakashkumar Shah, Parth Rohitkumar Shah
1. Associate Professor, Department of Medicine, Smt. B. K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India.
2. Consultant, Department of Anaesthesiology, Sterling Hospital, Vadodara, Gujarat, India.
Correspondence
Ronak Prakashkumar Shah,
104, Nakshtra Enclave Apartment, Behind Bright School, Near Amit Complex, VIP Road, Karelibaugh, Vadodara-390018, Gujarat, India.
E-mail: drronakshah@yahoo.com
Introduction: Acute Ischaemic Stroke (AIS) is a leading contributor to both mortality and long-term disability globally. Serum ferritin, an acute-phase reactant involved in iron metabolism, has been implicated in oxidative stress and neuronal damage in stroke patients. Exploring the relationship between serum ferritin levels, stroke severity, and functional outcomes can help improve risk assessment and optimise treatment strategies.
Aim: The present study aimed to evaluate the association between serum ferritin levels and stroke severity as assessed by the National Institutes of Health Stroke Scale (NIHSS) and functional outcomes measured by the Modified Rankin Scale (mRS). Additionally, the study sought to identify clinical and demographic factors associated with serum ferritin levels in AIS patients.
Materials and Methods: The present prospective cross-sectional study was conducted at the Critical Care Unit of Smt BK Shah Medical Institute and Research Hospital,Sumandeep VIdyapeeth Deemed to be University, Vadodara Gujarat, India, from January 2025 to February 2025. Ethical approval was obtained from the Institutional Ethics Committee. A total of 42 AIS patients meeting the inclusion criteria were enrolled. Serum ferritin levels were measured upon admission in all patients. Stroke severity was assessed using NIHSS at admission, and functional outcomes were evaluated using mRS on the seventh day. Statistical analyses, including Chi-square tests, were performed to determine associations, with a p-value <0.05 considered significant.
Results: The study included 42 patients with AIS with mean age of 56.10±7.19 years, with 24 (57.1%) patients being male and 25 (59.5%) patients residing in rural areas. Elevated serum ferritin levels was observed in 29 (69.1%) patients which was significantly associated with severe stroke (p=0.002) and worse functional outcomes (p<0.001). Severe stroke (higher NIHSS) was more common in female patients, smokers, urban residents, and cardiac disease and Transient Ischaemic Attack (TIA). Similarly, severe disability (higher mRS) was linked to female sex, smoking, and dyslipidaemia. Abnormal ferritin levels were significantly associated with female sex (p=0.01), smoking (p=0.004), cardiac disease (p=0.02), and TIA (p=0.03).
Conclusion: Serum ferritin levels were significantly associated with stroke severity and poor functional outcomes, indicating their potential role as a prognostic marker in AIS. Additionally, smoking, cardiac disease, and TIA history were linked to altered ferritin levels. These findings highlight the importance of ferritin as an inflammatory marker and its relevance in stroke management and risk stratification.
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