Department of Neurology, Baotou Central Hospital, Baotou, China; Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China.
Department of Neurology, Baotou Central Hospital, Baotou, China.
Clin Neurol Neurosurg. 2024 Sep;244:108451. doi: 10.1016/j.clineuro.2024.108451. Epub 2024 Jul 14.
Hydration plays a critical role in the pathophysiological progression of ischemic stroke. However, the impact of extreme hydration on the mortality of critically ill patients with ischemic stroke remains unclear. Therefore, our objective was to evaluate the association between hydration, as indicated by the blood urea nitrogen to creatinine ratio (UCR), and in-hospital mortality in critically ill patients with ischemic stroke.
Data from the Medical Information Mart for Intensive Care (MIMIC-IV) database were utilized. Patients with ischemic stroke admitted to the Intensive Care Unit (ICU) for the first time were identified. The exposure variable was the hydration state represented by the UCR. The study outcome measure was in-hospital mortality. The primary analytical approach involved multivariate Cox regression analysis. Kaplan-Meier curves were constructed, and subgroup analyses with interaction were performed.
A total of 1539 patients, with a mean age of 69.9 years, were included in the study. Kaplan-Meier curves illustrated that patients in higher UCR tertiles exhibited increased in-hospital mortality. Accordingly, the risk of in-hospital mortality significantly rose by 29 % with every 10 units increase in UCR. Subgroup analysis indicated a robust association between UCR and in-hospital mortality in each subgroup, with no statistically significant interactions observed.
Hydration status is significantly associated with in-hospital all-cause mortality in critically ill patients with ischemic stroke. This finding underscores the importance of closely monitoring critically ill patients for adequate hydration and implementing appropriate rehydration strategies.
水合作用在缺血性脑卒中的病理生理进展中起着关键作用。然而，极端水合状态对重症缺血性脑卒中患者的死亡率的影响尚不清楚。因此，我们的目的是评估血尿素氮与肌酐比值（UCR）所表示的水合状态与重症缺血性脑卒中患者住院死亡率之间的关系。
利用医疗信息监护网第四版（MIMIC-IV）数据库的数据。首次入住重症监护病房（ICU）的缺血性脑卒中患者被确定为研究对象。暴露变量为 UCR 所代表的水合状态。研究结局指标为住院死亡率。主要分析方法包括多变量 Cox 回归分析。构建 Kaplan-Meier 曲线，并进行具有交互作用的亚组分析。
共纳入 1539 例患者，平均年龄为 69.9 岁。Kaplan-Meier 曲线表明，UCR 较高三分位组的患者住院死亡率较高。因此，UCR 每增加 10 个单位，住院死亡率的风险显著增加 29%。亚组分析表明，UCR 与住院死亡率之间存在显著关联，且各亚组均无统计学显著交互作用。
水合状态与重症缺血性脑卒中患者的住院全因死亡率显著相关。这一发现强调了密切监测重症患者的水合状态并实施适当的补液策略的重要性。
