Applicability of Transcranial Doppler Marker in Survival rate of Ischemic Stroke Patient

Background: Ischemic stroke remains a leading cause of long-term disability and mortality worldwide. Accurate prognostic assessment is essential for clinical decision-making and management planning; however, commonly used clinical scales are limited by subjectivity, while advanced neuroimaging is costly and not always feasible at the bedside. Transcranial Doppler ultrasonography (TCD) offers a non-invasive, cost-effective, and repeatable method to assess cerebral hemodynamics, but evidence regarding its prognostic value for survival remains limited.Method: This retrospective cohort study included ischemic stroke patients admitted to the Gadjah Mada Stroke Center who met predefined inclusion criteria. TCD examinations were performed during hospitalization to evaluate cerebral hemodynamics, including peak systolic velocity (PSV), mean flow velocity (MFV), and pulsatility index (PI). Demographic data, vascular risk factors, baseline functional status, and cognitive function were recorded as potential confounders. Patient survival, defined as time from stroke diagnosis to death or last follow-up, was analyzed using multivariate Cox proportional hazards regression. A total of 30 patients were included, with an overall mortality rate of 40.0%.Result: Comparative analysis showed significantly higher PI values in the internal carotid, middle cerebral, and vertebral arteries among patients who died. In multivariate survival analysis, elevated PI (≥1.2) in the middle cerebral and vertebral arteries was independently associated with increased mortality risk. In addition, higher MFV in the internal carotid artery and increased PSV and MFV in the posterior cerebral artery were also associated with poorer survival.Conclusion: These findings suggest that TCD parameters, particularly pulsatility index, have prognostic significance for survival in ischemic stroke patients.