Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Eur J Neurol. 2024 Jul;31(7):e16296. doi: 10.1111/ene.16296. Epub 2024 Apr 8.
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.
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.
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 < 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 < 0.001).
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.
血清尿酸（SUA）与血清肌酐（SCr）的比值（代表肾功能归一化的 SUA）与急性缺血性脑卒中（AIS）患者的功能结局相关。然而，其对接受机械取栓（MT）的 AIS 患者的影响尚不清楚。本研究旨在探讨 SUA/SCr 比值对 MT 治疗的 AIS 患者临床结局的影响。
连续纳入 2018 年 1 月至 2023 年 6 月期间接受 MT 的急性缺血性脑卒中患者。入院时，在最初 24 小时内记录 SUA 和 SCr 水平。采用国立卫生研究院卒中量表（NIHSS）评分评估卒中严重程度。临床结局包括 90 天的不良功能结局（改良Rankin 量表评分>2）、症状性颅内出血和死亡。
在 734 名患者中，432 名（58.8%）在 90 天时有不良功能结局。SUA/SCr 比值与 NIHSS 评分呈负相关（ρ=-0.095，p=0.010）。单因素分析显示，SUA/SCr 比值与不良功能结局有显著关联。在校正混杂因素后，SUA/SCr 比值仍然是功能结局的独立预测因素（调整后的优势比 0.348，95%置信区间 0.282-0.428，p<0.001）。受试者工作特征曲线分析显示，SUA/SCr 比值预测功能结局的能力，截断值为 3.62，曲线下面积为 0.757（95%置信区间 0.724-0.788，p<0.001）。
SUA/SCr 比值与卒中严重程度相关，可能是 MT 治疗的 AIS 患者 90 天功能结局的预测指标。
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