Serum uric acid as an independent predictor of early death after acute stroke.
BACKGROUND
The prognostic significance of uric acid (UA) levels in acute stroke is unclear, so the objective of this study was to determine the association between levels of serum UA (SUA) and mortality in acute stroke.


RESULTS
Consecutive patients (n=435) presenting with ischemic stroke and intracerebral hemorrhage were included in the study. The length of stay in hospital and the occurrence of death were recorded. On univariate analysis, the occurrence of death was associated with older age, smoking, presence of congestive heart failure or atrial fibrillation, absence of hyperlipidemia, and intracerebral hemorrhage as the index event. Furthermore, glucose, urea, creatinine and SUA at admission were significantly higher in patients who died, whereas total and high-density-lipoprotein cholesterol were significantly lower. On multiple logistic regression analysis, the independent relationship between higher SUA levels and death was confirmed (odds ratio (OR), 1.37; 95%confidence interval (CI), 1.13-1.67; p=0.001). The only other variables independently associated with the occurrence of death were urea concentration and presence of atrial fibrillation. If urate was >7.8 mg/dl (0.47 mmol/L), then there would be a high probability of early death (87%).


CONCLUSIONS
Elevated levels of SUA are independently associated with an increased risk of early death in acute stroke.
Karagiannis
Asterios
A
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
Mikhailidis
Dimitri P
DP
Tziomalos
Konstantinos
K
Sileli
Maria
M
Savvatianos
Savvas
S
Kakafika
Anna
A
Gossios
Thomas
T
Krikis
Napoleon
N
Moschou
Irene
I
Xochellis
Michael
M
Athyros
Vassilios G
VG
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000097:blood / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000401:mortality*; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid