The influence of dehydration on the prognosis of acute ischemic stroke for patients treated with tissue plasminogen activator

BMC Cardiovascular Disorders

Y. H. Tsai¹  Chung-Jen Lin²  Leng-Chieh Lin²  Fei-Fan Wu²  Yen-Chu Hung³  Jiann-Der Lee³  Chia-Wei Liow⁴  Tsung-I Peng⁵  Jen-Tsung Yang⁶  Tsong-Hai Lee⁷ 

[1]Department of Diagnostic Radiology, Chang Gung University

[2]Department of Emergency Medicine, Chang Gung Memorial Hospital

[3]Department of Neurology, Chang Gung University

[4]Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University

[5]Department of Neurology, Keelung Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University

[6]Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, and College of Medicine, Chang Gung University

[7]Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University

关键词: Ischemic stroke;    Modified Rankin scale;    Barthel index;    Dehydration;    BUN/Cr;    Stroke registry;   

DOI  :  10.1186/s12872-017-0590-6

来源: DOAJ

【 摘 要 】

Abstract Background Many studies have determined that dehydration is an independent predictor of outcome after ischemic stroke (IS); however, none have determined if the use of thrombolytic therapy modifies the negative impact of poor hydration. To inform the stroke registry established at our institution, we conducted a retrospective study to determine if dehydration remains a negative prognostic factor after IS patients treated with tissue plasminogen activator (tPA). Methods Between 2007 and 2012, we recruited 382 subjects; 346 had data available and were divided into 2 groups on the basis of their blood urea nitrogen/creatinine (BUN/Cr) ratio. Dehydrated subjects had a BUN/Cr ratio ≥ 15; hydrated subjects had a BUN/Cr < 15. The primary outcome was impairment at discharge as graded by the Barthel Index (BI) and the modified Rankin Scale (mRS). Results The dehydration group had a greater mean age; more women; lower mean levels of hemoglobin, triglycerides, and sodium; and higher mean potassium and glucose levels. A favorable outcome as assessed by the mRS (≤2) was significantly less frequent among dehydrated subjects, but a favorable outcome by the BI (≥60) was not. Logistic regression and multivariate models confirmed that dehydration is an independent predictor of poor outcome by both the mRS and the BI; however, it was not predictive when patients were stratified by Trial of Org 10,172 in Acute Stroke Treatment subtype. Conclusions Our findings indicate that use of thrombolytic therapy does not eliminate the need to closely monitor hydration status in patients with IS.

【 授权许可】

Unknown