Hepatorenal and Full Blood Count Profiles of Stroke Survivors Compared With Controls: A Case-Control Study

Stroke is not merely a cerebrovascular event but a systemic disorder with multi-organ implications, including the liver and kidneys. Despite this growing body of knowledge, significant gaps persist. Most studies characterizing poststroke renal, hepatic, and hematological profiles originate from high-income settings, with limited data from sub-Saharan African populations who face distinct genetic, environmental, and healthcare access challenges. A case-control study was conducted at the Tamale Teaching Hospital between March and September 2025. The study involved 69 participants, aged 31-78 years, of whom 20 (29.0%) were stroke survivors (cases). Of the 69 participants, 39 (56.5%) were female. A single venous blood sample was collected and analyzed for full blood count, liver and renal function variables. Bivariate analysis revealed no significant differences in liver and renal function; however, the mean cell volume (MCV [fL]), the red cell distribution width (RDW-CV [%]), eosinophils (%), and plateletcrit (PCT [%]) were lower, whereas the mean cell hemoglobin concentration (MCHC [g/dL]) was higher in the stroke group. After adjusting for confounders, including body mass index (BMI) and occupation, the indirect bilirubin level was 0.143 mmol/L higher in the stroke group. In addition, the MCHC was 0.398 g/dL higher, while the hematocrit (HCT), MCV, and RDW-CV were lower in the stroke group by 0.206 (%), 0.121 (fL), and 0.514 (%), respectively. This study suggests that stroke survivors exhibit distinct hematological profiles, characterized by alterations in RBC morphology and possibly low-grade hemolysis or altered bilirubin metabolism independent of major liver or renal dysfunction. These changes may reflect the persistent systemic inflammation, oxidative stress, and erythropoietic adaptation following a stroke.