Wang Anxin, Tian Xue, Gu Hongqiu, Zuo Yingting, Meng Xia, Chen Pan, Li Hao, Wang Yongjun
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Ann Transl Med. 2021 Jul;9(13):1069. doi: 10.21037/atm-21-741.
Abnormal electrolytes were closely related to the prognosis of various diseases, the prognostic role of electrolytes in stroke has not been investigated well. We aimed to investigate the association between electrolytes and clinical outcomes in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA).
Data were recruited from the China National Stroke Registry III study. Patients were classified into three groups according to tertiles and the normal range of each electrolyte. Multivariable logistic and Cox proportional hazards regressions were adopted to explore the associations of electrolytes with poor functional outcomes [modified Rankin Scale (mRS) 3-6/2-6] and all-cause death at 3 months and 1 year.
A total of 10,299 eligible patients were enrolled. After adjusted for confounding factors, the first tertile electrolytes were associated with increased risk of poor functional outcome (mRS score 3-6) at 1 year, the adjusted odds ratios (95% confidence intervals) were 1.33 (1.14-1.55) for potassium, 1.41 (1.20-1.60) for sodium, 1.27 (1.08-1.48) for chloride, compared with the second tertile. Similar results were found when poor functional outcome was defined as mRS score 2-6 and all-cause death. However, almost no significant association was present of calcium with these outcomes. All results were consistent when each electrolyte was classified into three groups according to the normal range and the outcomes timepoint was set at 3 months.
Lower levels of potassium, sodium, chloride but not calcium were associated with higher risk of poor functional outcomes and death in patients with AIS or TIA.
电解质异常与多种疾病的预后密切相关，然而电解质在卒中预后中的作用尚未得到充分研究。我们旨在探讨急性缺血性卒中（AIS）或短暂性脑缺血发作（TIA）患者电解质与临床结局之间的关联。
数据来自中国国家卒中登记研究III。根据每种电解质的三分位数和正常范围将患者分为三组。采用多变量逻辑回归和Cox比例风险回归分析，探讨电解质与3个月和1年时功能预后不良[改良Rankin量表（mRS）评分3 - 6/2 - 6]及全因死亡之间的关联。
共纳入10299例符合条件的患者。校正混杂因素后，与第二三分位数相比，第一三分位数的电解质与1年时功能预后不良（mRS评分3 - 6）风险增加相关，钾的校正比值比（95%置信区间）为1.33（1.14 - 1.55），钠为1.41（1.20 - 1.60），氯为1.27（1.08 - 1.48）。当将功能预后不良定义为mRS评分2 - 6和全因死亡时，也发现了类似结果。然而，钙与这些结局几乎无显著关联。当根据正常范围将每种电解质分为三组且结局时间点设定为3个月时，所有结果均一致。
AIS或TIA患者中，较低水平的钾、钠、氯而非钙与功能预后不良和死亡风险较高相关。
