Working Paper Article Version 1 This version is not peer-reviewed

Extremely Low Alanine Aminotransferase Level Increases All-Cause Mortality Rate in the Elderly after Ischemic Strok

Version 1 : Received: 17 March 2021 / Approved: 19 March 2021 / Online: 19 March 2021 (08:09:52 CET)

A peer-reviewed article of this Preprint also exists.

An, S.J.; Yang, Y.-J.; Jeon, N.-M.; Hong, Y.-P.; Kim, Y.I.; Kim, D.-Y. Significantly Reduced Alanine Aminotransferase Level Increases All-Cause Mortality Rate in the Elderly after Ischemic Stroke. Int. J. Environ. Res. Public Health 2021, 18, 4915. An, S.J.; Yang, Y.-J.; Jeon, N.-M.; Hong, Y.-P.; Kim, Y.I.; Kim, D.-Y. Significantly Reduced Alanine Aminotransferase Level Increases All-Cause Mortality Rate in the Elderly after Ischemic Stroke. Int. J. Environ. Res. Public Health 2021, 18, 4915.

Journal reference: Int. J. Environ. Res. Public Health 2021, 18, 4915
DOI: 10.3390/ijerph18094915

Abstract

(1) Background: Extremely low alanine aminotransferase (ALT) levels are be-ing recognized as a risk factor of increasing mortality in the elderly in relation to frailty. In the elderly, both frailty and ischemic stroke are not only common, but also associated with mortality. This study aimed to investigate whether extremely low ALT levels increase the all-cause mortality rate in the elderly after ischemic stroke. (2) Methods: A retrospective review was performed on 901 patients with ischemic stroke admitted to a university-affiliated hospital between February 2014 and April 2019. The multivariate Cox proportional hazard analysis was performed to determine whether extremely low ALT lev-els are an independent risk factor of mortality in elderly patients after ischem-ic stroke. (3) Results: This study enrolled 323 older adults (age ≥65 years) who were first diagnosed with ischemic stroke. The mean age of the participants was 76.5 ± 6.6 years, mean survival time was 37.1 ± 20.4 months, and the num-ber of deaths was 96 (29.7%). The multivariate Cox proportional hazard analy-sis revealed that the risk factors for all-cause mortality in the elderly after is-chemic stroke were age, initial National Institutes of Health Stroke Scale score, serum creatinine, and extremely low ALT level (<10 U/L) at the time of diag-nosis (adjusted hazard ratio: 3.243, 95% confidence interval: 1.945–5.408; P < 0.001) (4) Conclusions: Extremely low ALT level at the time of diagnosis (<10 U/L) is an independent risk factor that increases the mortality rate in the el-derly after ischemic stroke.

Keywords

Aged; Alanine Transaminase; Brain infarction; Frailty; Mortality

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