Effects of admission serum urea, glomerular filtration rate, proteinuria and diabetes status on 3-month mortality after acute stroke

Idris, Iskandar; Hill, Robert G.; Sharma, Jagdish C.

doi:10.1177/1479164109360486

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Case fatalities in the literature ranged between 10 and 22% (7,9,34), and 1- and 5-year mortalities were 27 and 53%, respectively (10). Only a few studies investigated mortality after stroke in diabetic and nondiabetic patients (10–12,35,36); however, these studies were in part clinic based and analyzed only single subtypes of stroke or shorter periods of follow-up. In the study by Rautio et al (10), only case fatality was investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, we are in line with the Rautio et al (10) study that finds diabetic women have a higher excess risk to die within the first course after stroke; on the other hand, Rautio et al (10) did not find lower risks for diabetic men. A further study analyzes the 3-month mortality in a clinic-based sample and finds diabetes to be a significant predictor of mortality (35). …”

Section: Discussionmentioning

confidence: 99%

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Time-Dependent Impact of Diabetes on Mortality in Patients With Stroke

et al. 2012

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OBJECTIVETo estimate the impact of diabetes on mortality in patients after first stroke event.RESEARCH DESIGN AND METHODSUsing claims data from a nationwide statutory health insurance fund (Gmünder ErsatzKasse), we assessed all deaths in a cohort of 5,757 patients with a first stroke between 2005 and 2007 (69.3% male, mean age 68.1 years, 32.2% with diabetes) up to 2009. By use of Cox regression, we estimated time-dependent hazard ratios (HRs) to compare patients with and without diabetes stratified by sex.RESULTSThe cumulative 5-year mortality was 40.0 and 54.2% in diabetic men and women, and 32.3 and 38.1% in their nondiabetic counterparts, respectively. In males, mortality was significantly lower in diabetic compared with nondiabetic patients in the first 30 days (multiple-adjusted HR 0.67 [95% CI 0.53–0.84]). After approximately a quarter of a year, the diabetes risk increased, yielding crossed survival curves. Later on, mortality risk tended to be similar in diabetic and nondiabetic men (1–2 years: 1.42 [1.09–1.85]; 3–5 years: 1.00 [0.67–1.41]; time dependency of diabetes, P = 0.008). In women, the pattern was similar; however, time dependency was not statistically significant (P = 0.89). Increasing age, hemorrhagic stroke, renal failure (only in men), levels of care dependency, and number of prescribed medications were significantly associated with mortality.CONCLUSIONSWe found a time-dependent mortality risk of diabetes after first stroke in men. Possible explanations may be type of stroke or earlier and more intensive treatment of risk factors in diabetic patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Time-Dependent Impact of Diabetes on Mortality in Patients With Stroke

et al. 2012

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“…Therefore, serum urea could be applied as a surrogate parameter for the severity of the underlying diseases and comorbidities and not only as a parameter for a single-organ dysfunction. On this account, several studies reported the association of elevated serum urea levels and increased mortality in patients with hip fractures, small lung cell cancer, acute strokes, and patients with ischemic strokes which were treated with intravenous tissue plasminogen activators [34][35][36][37]. In contrast, negative acute-phase protein albumin is an important clinical indicator of current nutrition status and liver synthesis function of patients, and an appropriate biomarker for the prediction of inflammatory diseases and mortality after septic shock and ICH as well as community-acquired bloodstream infections [11,14,26].…”

Section: Serum Urea-to-albumin Ratiomentioning

confidence: 99%

Serum Urea-to-Albumin Ratio Is an Independent Predictor of Intra-Hospital Mortality in Neurosurgical Intensive Care Unit Patients with Spontaneous Intracerebral Hemorrhage

Bender

Haferkorn

Tajmiri-Gondai

et al. 2023

JCM

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The negative prognostic value of an increased serum urea-to-albumin ratio on intra-hospital mortality is frequently investigated in general critically ill patients and patients with septic shock, although not in neurosurgical patients with spontaneous intracerebral hemorrhages (ICH). The current study was conducted to investigate the impact of the serum urea-to-albumin ratio upon hospital admission on intra-hospital mortality in ICU-admitted neurosurgical patients with spontaneous ICH. Methods: This retrospective study analyzed 354 ICH patients, who were treated from 10/2008 to 12/2017 at our intensive care units (ICU). Blood samples were taken upon admission, and the patients’ demographic, medical, and radiological data were analyzed. A binary logistic regression analysis was performed for the identification of independent prognostic parameters for intra-hospital mortality. Results: Overall, the intra-hospital mortality rate was 31.4% (n = 111). In the binary logistic analysis, a higher serum urea-to-albumin ratio (OR = 1.9, CI = 1.23–3.04, p = 0.005) upon admission was identified as an independent predictor of intra-hospital mortality. Furthermore, a serum urea-to-albumin ratio cut-off level of >0.01 was associated with raised intra-hospital mortality (Youden’s index = 0.32, sensitivity = 0.57, specificity = 0.25). Conclusion: A serum urea-to-albumin ratio greater than 1.1 seems to be a prognostic marker to predict intra-hospital mortality in patients with ICH.

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“…Patients with diabetes have an eight times higher risk of stroke, compared to the general population , with a poor prognosis . Furthermore, as diabetes doubles the risk of developing depression, patients with diabetes are more likely to use selective serotonin reuptake inhibitors (SSRIs) .…”

Section: Introductionmentioning

confidence: 99%