Elevated blood urea nitrogen/creatinine ratio is associated with poor outcome in patients with ischemic stroke
Clinical Neurology and Neurosurgery, 07/27/2012
Schrock JW et al. - An elevated blood urea nitrogen to creatinine ratio (BUN/Cr) ratio in patients with acute ischemic stroke (AIS) is associated with poor outcome at 30 days.Methods
- The authors conducted a prospective cohort study using a stroke registry enrolling all ED patients with AIS from 10/2007 through 6/2009.
- Poor clinical outcome was defined as death, placement in a nursing home for purposes other than rehabilitation, or hospice within 30 days of ED presentation.
- A BUN/Cr ratio of ≥15 was considered elevated. (IQR).
- Logistic regression was performed adjusted for age >64 years, NIHSS >8, diabetes, prior CVA, and coma at presentation reporting odds ratios with 95% confidence intervals.
- 324 patients had a final diagnosis of AIS. 163 (50%) were female, 19 (6%) died, 44 (14%) received t-PA, and 89 (27%) had a poor clinical outcome.
- The median NIHSS, BUN and Cr were 4 (IQR 1–9), 14mg/dL (IQR 11–21), and 1.02mg/dL (IQR 0.87–1.27) respectively.
- The median BUN/Cr was 13.9 (IQR 10.6–18.5).
- The variables associated with a poor clinical outcome were: high NIHSS OR 6.5 (3.6–11.8), age >64 years OR 2.7 (1.5–5.0), and BUN/Cr ratio of ≥15 OR 2.2 (1.2–4.0).