Yi Yang MD, Departments of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China, E-mail:
J Nutr Health Aging. 2021;25(3):335-339. doi: 10.1007/s12603-020-1495-0.
As a very common risk of adverse outcomes of the ischemic stroke patients, sarcopenia is associated with infectious complications and higher mortality. The goal of this retrospective study is to explore the predictive value of serum Cr/CysC ratio in acute ischemic stroke patients receiving nutritional intervention.
We reviewed adult patients with AIS from December 2019 to February 2020. Patients with acute kidney injury were excluded and all patients received nutritional intervention during a 3-month follow-up period. We collected baseline data at admission including creatinine and cystatin C. The primary poor outcome was major disability (modified Rankin Scale score ≥ 4) at 3 months after AIS.
A total of 217 patients with AIS were identified for this study. Serum Cr/CysC ratio was significantly correlated with NIHSS at discharge, 1-month modified Rankin Scale score, and 3-month modified Rankin Scale score. During 3 months, 34 (15.70%) patients had a poor outcome after AIS and 11 (5.10%) patients died within 30 days. In multivariable logistic regression analyses, serum Cr/CysC ratio at admission was independently associated with 3-month poor outcomes (OR: 0.953, 95% CI: 0.921-0.986, p = .006) and 30-day mortality (OR: 0.953, 95% CI: 0.921-0.986, p = .006).
As a blood biochemical indexes reflecting the muscle mass and aiding in risk stratification, Cr/CysC ratio at admission could be used as a predictor of 30-day mortality and long-term poor prognosis in AIS patients.
肌少症是缺血性脑卒中患者不良预后的一个非常常见的风险因素,与感染并发症和更高的死亡率相关。本回顾性研究的目的是探讨血清 Cr/CysC 比值在接受营养干预的急性缺血性脑卒中患者中的预测价值。
我们回顾了 2019 年 12 月至 2020 年 2 月期间的成人 AIS 患者。排除急性肾损伤患者,所有患者在 3 个月的随访期间均接受营养干预。我们收集入院时的基线数据,包括肌酐和胱抑素 C。主要不良结局是 AIS 后 3 个月时的主要残疾(改良 Rankin 量表评分≥4)。
本研究共纳入 217 例 AIS 患者。血清 Cr/CysC 比值与出院时 NIHSS、1 个月改良 Rankin 量表评分和 3 个月改良 Rankin 量表评分显著相关。在 3 个月内,34 例(15.70%)患者 AIS 后预后不良,30 天内 11 例(5.10%)患者死亡。多变量逻辑回归分析显示,入院时血清 Cr/CysC 比值与 3 个月时的不良预后(OR:0.953,95%CI:0.921-0.986,p=0.006)和 30 天死亡率(OR:0.953,95%CI:0.921-0.986,p=0.006)独立相关。
作为反映肌肉量并有助于风险分层的血液生化指标,入院时的 Cr/CysC 比值可作为 AIS 患者 30 天死亡率和长期预后不良的预测指标。