Title: Pattern of change of serum uric acid level during acute ischemic stroke and their prognostic significance
Authors: Dr Sonika Pandey, Dr K K Kawre, Dr P. Dwivedi
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.171
Abstract
In Acute ischemic stroke (AIS) there is cascade of inflammatory reaction, and uric acid exert beneficial role in AIS due to its strong antioxidant property.
Aim: Aim was to study the pattern of change in serum uric acid (SUA) level and the association between SUA level at presentation and the clinical outcome in AIS patient.
Methodology: Single centre prospective cross sectional analytical hospital based time bound study. 100 consecutive patients admitted with AIS in medicine emergency were enrolled for study after considering the inclusion and exclusion criteria. Prognostic significance of SUA were analysed in term of NIHSS (national institute of health stroke scale) score (at admission, discharge, 90 days), hospital stay, and survival (at 90 days). Student t test and χ2 test was used to compare continuous and categorical variables respectively. Kaplain Meier survival plot was used for survival analysis.
Results: Mean SUA was (6.23mg/dl, SD±1.2) at admission, (5.64mg/dl, SD±0.98) discharge, (5.28mg/dl, SD±0.82) 90 days. Mean SUA shows significant inverse correlation with NIHSS score (p <0.0001, 0.001, 0.004 with r = -0.382,-0.403,-0.357) at admission, discharge and 90 days respectively. SUA shows significant negative correlation with hospital stay (p= 0.004, r= -0.342). The odds ratio of SUA at admission (cut off < 5.5 mg/dL) was 5.962 (2.08-17.09; CI 95%) showing more survival for SUA at admission > 5.5 mg/dL. The mortality rate, hospital stay, NIHSS score was found to be more in patient having diabetes or metabolic syndrome.
Conclusions: SUA is consumed during AIS. Higher SUA level is associated with low NIHSS score, reduced hospital stay, more survival and may act as good prognostic marker.
Keyword: AIS (acute ischemic stroke); SUA (serum uric acid); NIHSS (national institute of health stroke scale).
