Abstract T P357: Low Baseline Urine Creatinine Excretion Rate Independently Predicts Severe Disability or Death among Critically Ill Acute Stroke Patients
Background: Urinary creatinine excretion rate (CER) is an established marker of muscle mass and by extension possibly an indicator of physical fitness and cardiovascular structure or function. Low CER has been linked to poor coronary artery disease outcomes, but a link between CER and acute stroke prognosis has not been previously explored.
Objective: To evaluate whether low baseline CER is associated with poor outcomes among critically ill acute stroke patients.
Methods: We prospectively collected data from patients with acute stroke (ischemic or hemorrhagic) within 24 hours from symptom onset, admitted to a Neurological and Neurosurgery Intensive Care Unit in a hospital in Taiwan between September 2007 and October 2010. Baseline CER (mg/d) was calculated based on 24-hour urine volume and urine creatinine data. Patients were divided into 3 groups according to highest, middle, and lowest CER. Primary endpoint was poor outcome defined as modified Rankin Scale 3-6 at 6 months. Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) for the 6-month mRS were computed using backward stepwise regression analysis.
Results: Among 167 critically ill acute stroke patients meeting study entry criteria, 102 (61%) were men, mean age was 68.7 years, 93 (56%) patients had ischemic stroke. Compared to patients in the group with the highest CER levels, patients in the group with the lowest CER levels were older, and had lower body mass index. Patients with lowest CER had poor 6-month outcomes after adjustment for relevant covariates (OR 4.48, 95% CI 1.22 to 16.43, P = 0.024) (Table).
Conclusions: Among critically-ill acute stroke patients, low baseline CER was independently associated with poor 6-month outcomes. Validation in other patient populations and a better understanding of the pathophysiologic mechanisms at play is warranted.
Author Disclosures: C. Hsu: None. Y. Wu: None. Y. Huang: None. J. Lee: None. M. Lee: None. C. Wu: None. H. Hsu: None. Y. Lin: None. Y. Huang: None. H. Yang: None. J. Yang: None. M. Lee: None. B. Ovbiagele: None.
- © 2014 by American Heart Association, Inc.