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

BMC Cardiovascular Disorders

Research Article

Y. H. Tsai¹  Chung-Jen Lin²  Fei-Fan Wu²  Leng-Chieh Lin³  Jiann-Der Lee⁴  Yen-Chu Hung⁵  Chia-Wei Liow⁶  Tsung-I Peng⁷  Jen-Tsung Yang⁸  Tsong-Hai Lee⁹ 

[1]Department of Diagnostic Radiology, Chang Gung University, Taoyuan, Taiwan

[2]Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan

[3]Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., 613, Puzih City, Chiayi County, Taiwan, ROC

[4]Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., 613, Puzih City, Chiayi County, Taiwan, ROC

[5]Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan

[6]Department of Neurology, Chang Gung University, Taoyuan, Taiwan

[7]Department of Neurology, Chang Gung University, Taoyuan, Taiwan

[8]Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan

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

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

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

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

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

DOI  :  10.1186/s12872-017-0590-6

 received in 2016-11-16, accepted in 2017-06-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMany 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).MethodsBetween 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).ResultsThe 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.ConclusionsOur 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】

CC BY   
© The Author(s). 2017