Lower serum uric acid to serum creatinine ratio as a predictor of poor functional outcome after mechanical thrombectomy in acute ischaemic stroke

Background and purpose The ratio of serum uric acid (SUA) to serum creatinine (SCr), representing normalized SUA for renal function, is associated with functional outcome in acute ischaemic stroke (AIS) patients. However, its effect on AIS patients undergoing mechanical thrombectomy (MT) remains unk...

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Published in:European journal of neurology 2024-07, Vol.31 (7), p.e16296-n/a
Main Authors: Xu, Jinghan, Jiang, Xin, Liu, Qian, Liu, Jiaxin, Fang, Jinghuan, He, Li
Format: Article
Language:English
Subjects:
acute ischaemic stroke
clinical outcome
Creatinine
Hemorrhage
Ischemia
mechanical thrombectomy
Renal function
serum uric acid to serum creatinine ratio
Stroke
stroke severity
Uric acid
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Jiang, Xin
Liu, Qian
Liu, Jiaxin
Fang, Jinghuan
He, Li
description Background and purpose The ratio of serum uric acid (SUA) to serum creatinine (SCr), representing normalized SUA for renal function, is associated with functional outcome in acute ischaemic stroke (AIS) patients. However, its effect on AIS patients undergoing mechanical thrombectomy (MT) remains unknown. This study aimed to investigate the influence of the SUA/SCr ratio on clinical outcome in MT‐treated AIS patients. Methods Acute ischaemic stroke patients who underwent MT were continuously enrolled from January 2018 to June 2023. Upon admission, SUA and SCr levels were recorded within the initial 24 h. Stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS) score. Clinical outcome included poor functional outcome (modified Rankin Scale score >2) at 90 days, symptomatic intracranial haemorrhage and death. Results Amongst 734 patients, 432 (58.8%) exhibited poor functional outcome at 90 days. The SUA/SCr ratio exhibited a negative correlation with NIHSS score (ρ = −0.095, p = 0.010). Univariate analysis revealed a significant association between SUA/SCr ratio and poor functional outcome. After adjusting for confounders, the SUA/SCr ratio remained an independent predictor of functional outcome (adjusted odds ratio 0.348, 95% confidence interval 0.282–0.428, p 
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However, its effect on AIS patients undergoing mechanical thrombectomy (MT) remains unknown. This study aimed to investigate the influence of the SUA/SCr ratio on clinical outcome in MT‐treated AIS patients. Methods Acute ischaemic stroke patients who underwent MT were continuously enrolled from January 2018 to June 2023. Upon admission, SUA and SCr levels were recorded within the initial 24 h. Stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS) score. Clinical outcome included poor functional outcome (modified Rankin Scale score &gt;2) at 90 days, symptomatic intracranial haemorrhage and death. Results Amongst 734 patients, 432 (58.8%) exhibited poor functional outcome at 90 days. The SUA/SCr ratio exhibited a negative correlation with NIHSS score (ρ = −0.095, p = 0.010). Univariate analysis revealed a significant association between SUA/SCr ratio and poor functional outcome. After adjusting for confounders, the SUA/SCr ratio remained an independent predictor of functional outcome (adjusted odds ratio 0.348, 95% confidence interval 0.282–0.428, p &lt; 0.001). Receiver operating characteristic curve analysis highlighted the ability of the SUA/SCr ratio to predict functional outcome, with a cutoff value of 3.62 and an area under the curve of 0.757 (95% confidence interval 0.724–0.788, p &lt; 0.001). Conclusion The SUA/SCr ratio is correlated with stroke severity and may serve as a predictor of 90‐day functional outcome in AIS patients undergoing MT.</description><identifier>ISSN: 1351-5101</identifier><identifier>ISSN: 1468-1331</identifier><identifier>EISSN: 1468-1331</identifier><identifier>DOI: 10.1111/ene.16296</identifier><identifier>PMID: 38588211</identifier><language>eng</language><publisher>England: John Wiley &amp; Sons, Inc</publisher><subject>acute ischaemic stroke ; clinical outcome ; Creatinine ; Hemorrhage ; Ischemia ; mechanical thrombectomy ; Renal function ; serum uric acid to serum creatinine ratio ; Stroke ; stroke severity ; Uric acid</subject><ispartof>European journal of neurology, 2024-07, Vol.31 (7), p.e16296-n/a</ispartof><rights>2024 The Authors. published by John Wiley &amp; Sons Ltd on behalf of European Academy of Neurology.</rights><rights>2024 The Authors. European Journal of Neurology published by John Wiley &amp; Sons Ltd on behalf of European Academy of Neurology.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). 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However, its effect on AIS patients undergoing mechanical thrombectomy (MT) remains unknown. This study aimed to investigate the influence of the SUA/SCr ratio on clinical outcome in MT‐treated AIS patients. Methods Acute ischaemic stroke patients who underwent MT were continuously enrolled from January 2018 to June 2023. Upon admission, SUA and SCr levels were recorded within the initial 24 h. Stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS) score. Clinical outcome included poor functional outcome (modified Rankin Scale score &gt;2) at 90 days, symptomatic intracranial haemorrhage and death. Results Amongst 734 patients, 432 (58.8%) exhibited poor functional outcome at 90 days. The SUA/SCr ratio exhibited a negative correlation with NIHSS score (ρ = −0.095, p = 0.010). Univariate analysis revealed a significant association between SUA/SCr ratio and poor functional outcome. After adjusting for confounders, the SUA/SCr ratio remained an independent predictor of functional outcome (adjusted odds ratio 0.348, 95% confidence interval 0.282–0.428, p &lt; 0.001). Receiver operating characteristic curve analysis highlighted the ability of the SUA/SCr ratio to predict functional outcome, with a cutoff value of 3.62 and an area under the curve of 0.757 (95% confidence interval 0.724–0.788, p &lt; 0.001). 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However, its effect on AIS patients undergoing mechanical thrombectomy (MT) remains unknown. This study aimed to investigate the influence of the SUA/SCr ratio on clinical outcome in MT‐treated AIS patients. Methods Acute ischaemic stroke patients who underwent MT were continuously enrolled from January 2018 to June 2023. Upon admission, SUA and SCr levels were recorded within the initial 24 h. Stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS) score. Clinical outcome included poor functional outcome (modified Rankin Scale score &gt;2) at 90 days, symptomatic intracranial haemorrhage and death. Results Amongst 734 patients, 432 (58.8%) exhibited poor functional outcome at 90 days. The SUA/SCr ratio exhibited a negative correlation with NIHSS score (ρ = −0.095, p = 0.010). Univariate analysis revealed a significant association between SUA/SCr ratio and poor functional outcome. After adjusting for confounders, the SUA/SCr ratio remained an independent predictor of functional outcome (adjusted odds ratio 0.348, 95% confidence interval 0.282–0.428, p &lt; 0.001). Receiver operating characteristic curve analysis highlighted the ability of the SUA/SCr ratio to predict functional outcome, with a cutoff value of 3.62 and an area under the curve of 0.757 (95% confidence interval 0.724–0.788, p &lt; 0.001). Conclusion The SUA/SCr ratio is correlated with stroke severity and may serve as a predictor of 90‐day functional outcome in AIS patients undergoing MT.</abstract><cop>England</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>38588211</pmid><doi>10.1111/ene.16296</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2034-1027</orcidid><oa>free_for_read</oa></addata></record>
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subjects acute ischaemic stroke
clinical outcome
Creatinine
Hemorrhage
Ischemia
mechanical thrombectomy
Renal function
serum uric acid to serum creatinine ratio
Stroke
stroke severity
Uric acid
title Lower serum uric acid to serum creatinine ratio as a predictor of poor functional outcome after mechanical thrombectomy in acute ischaemic stroke
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