Abstract
Background
Blood urea nitrogen (BUN)/creatinine (Cr) ratio was recently reported to be an independent
predictor of stroke-in-evolution (SIE) among patients who had suffered acute ischemic
stroke. We aim to determine if providing hydration therapy to patients with a BUN/Cr
≥15 reduces the occurrence of SIE after acute ischemic stroke.
Methods
This prospective interventional study included 189 patients (hydration group, n =
92; control group, n = 97) with acute ischemic stroke and a BUN/Cr ≥15. Hydration group received intravenous bolus (300-500 mL) saline followed by a maintenance
saline infusion (40-80 mL/h for the first 72 h), while control group received maintenance
saline infusion (40-60 mL/h for the first 24 h and 0-60 mL/h for 24-72 h). The study
endpoint was the proportion of patients who developed SIE within the first three days
of emergency department admission.
Results
There were no significant differences in demographic or clinical characteristics between
both groups. Patients in the hydration group received a significantly larger (all
P < 0.001) median volume of infused saline than patients in the control group on Days
1 (2400 vs 1440 mL), 2 (1440 vs 0 mL), and 3 (1000 vs 0 mL). The proportion of patients
who experienced SIE was significantly lower in the hydration group (9/92; 9.8%) compared
with the control group (21/97; 21.6%) (Fig. 1, P = 0.026).
Conclusions
Our preliminary findings suggest that providing patients with acute ischemic stroke
hydration therapy on the basis of their presenting BUN/Cr ratio may help reduce the
occurrence of SIE and therefore improve prognosis.
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Article Info
Publication History
Published online: April 07, 2014
Accepted:
March 29,
2014
Received in revised form:
March 28,
2014
Received:
September 5,
2013
Footnotes
☆Source of support: This work was supported by Grants CMRPG690431, CMRPG690441 and CMRPG690201 from the Chang Gung Medical Research Council.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
