Uric Acid and Clinical Outcomes Among Intracerebral Hemorrhage Patients: Results From the China Stroke Center Alliance
Background and Purpose: The effect of uric acid (UA) levels on severity and prognosis of spontaneous intracerebral hemorrhage (ICH) remains controversial. We aimed to explore the association of admission UA levels with stroke severity and outcomes in ICH patients.Materials and Methods: The patients...
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Frontiers Media S.A.
2020-12-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2020.609938/full |
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| author | Xinmin Liu Xinmin Liu Zhentang Cao Zhentang Cao Hongqiu Gu Hongqiu Gu Hongqiu Gu Hongqiu Gu Kaixuan Yang Kaixuan Yang Kaixuan Yang Kaixuan Yang Ruijun Ji Ruijun Ji Ruijun Ji Ruijun Ji Zixiao Li Zixiao Li Zixiao Li Zixiao Li Xingquan Zhao Xingquan Zhao Xingquan Zhao Xingquan Zhao Yongjun Wang Yongjun Wang Yongjun Wang Yongjun Wang |
| author_facet | Xinmin Liu Xinmin Liu Zhentang Cao Zhentang Cao Hongqiu Gu Hongqiu Gu Hongqiu Gu Hongqiu Gu Kaixuan Yang Kaixuan Yang Kaixuan Yang Kaixuan Yang Ruijun Ji Ruijun Ji Ruijun Ji Ruijun Ji Zixiao Li Zixiao Li Zixiao Li Zixiao Li Xingquan Zhao Xingquan Zhao Xingquan Zhao Xingquan Zhao Yongjun Wang Yongjun Wang Yongjun Wang Yongjun Wang |
| author_sort | Xinmin Liu |
| collection | DOAJ |
| description | Background and Purpose: The effect of uric acid (UA) levels on severity and prognosis of spontaneous intracerebral hemorrhage (ICH) remains controversial. We aimed to explore the association of admission UA levels with stroke severity and outcomes in ICH patients.Materials and Methods: The patients enrolled in this study were from the China Stroke Center Alliance study (CSCA). Patients were divided into four groups (Q1–Q4) according to the quartiles of UA levels at admission. The primary outcome was in-hospital mortality. The secondary outcomes included stroke severity, in-hospital complications, and discharge disposition. Multivariate logistic regression was adopted to explore the association of UA levels with outcomes after ICH.Results: Patients (84,304) with acute ICH were included in the final analysis; the median (interquartile range) of UA was 277 (210, 354) μmol/L. The four groups were defined as follows: Q1 ≤ 210 μmol/L, 210 μmol/L < Q2 ≤ 277 μmol/L, 277 μmol/L < Q3 ≤ 354 μmol/L, Q4 > 354 μmol/L. There was no significant evidence indicating that UA levels were correlated with the discharge disposition and in-hospital mortality after ICH. However, compared to Q1, the patients with higher UA levels had decreased odds of severe stroke (NIHSS ≥ 16) at admission (OR 0.89, 95% CI 0.86–0.92). An L-shaped association was found between UA and severe stroke. Among in-hospital complications, decrease in pneumonia, poor swallow function, gastrointestinal bleeding, and deep vein thrombosis (DVT) were significantly associated with higher UA levels compared to Q1 (P for trend < 0.0001).Conclusions: UA was a protective factor for stroke severity and in-hospital complications such as pneumonia, poor swallow function, gastrointestinal bleeding, and DVT. However, no significant evidence indicated that UA levels were predictive of the discharge disposition and in-hospital mortality after ICH. |
| first_indexed | 2024-12-20T01:07:39Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-20T01:07:39Z |
| publishDate | 2020-12-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-766c9a84e9ad49dab60778e3cc1316e92022-12-21T19:58:47ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-12-011110.3389/fneur.2020.609938609938Uric Acid and Clinical Outcomes Among Intracerebral Hemorrhage Patients: Results From the China Stroke Center AllianceXinmin Liu0Xinmin Liu1Zhentang Cao2Zhentang Cao3Hongqiu Gu4Hongqiu Gu5Hongqiu Gu6Hongqiu Gu7Kaixuan Yang8Kaixuan Yang9Kaixuan Yang10Kaixuan Yang11Ruijun Ji12Ruijun Ji13Ruijun Ji14Ruijun Ji15Zixiao Li16Zixiao Li17Zixiao Li18Zixiao Li19Xingquan Zhao20Xingquan Zhao21Xingquan Zhao22Xingquan Zhao23Yongjun Wang24Yongjun Wang25Yongjun Wang26Yongjun Wang27Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaCenter of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaCenter of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaCenter of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaCenter of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaCenter of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaCenter of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, ChinaBackground and Purpose: The effect of uric acid (UA) levels on severity and prognosis of spontaneous intracerebral hemorrhage (ICH) remains controversial. We aimed to explore the association of admission UA levels with stroke severity and outcomes in ICH patients.Materials and Methods: The patients enrolled in this study were from the China Stroke Center Alliance study (CSCA). Patients were divided into four groups (Q1–Q4) according to the quartiles of UA levels at admission. The primary outcome was in-hospital mortality. The secondary outcomes included stroke severity, in-hospital complications, and discharge disposition. Multivariate logistic regression was adopted to explore the association of UA levels with outcomes after ICH.Results: Patients (84,304) with acute ICH were included in the final analysis; the median (interquartile range) of UA was 277 (210, 354) μmol/L. The four groups were defined as follows: Q1 ≤ 210 μmol/L, 210 μmol/L < Q2 ≤ 277 μmol/L, 277 μmol/L < Q3 ≤ 354 μmol/L, Q4 > 354 μmol/L. There was no significant evidence indicating that UA levels were correlated with the discharge disposition and in-hospital mortality after ICH. However, compared to Q1, the patients with higher UA levels had decreased odds of severe stroke (NIHSS ≥ 16) at admission (OR 0.89, 95% CI 0.86–0.92). An L-shaped association was found between UA and severe stroke. Among in-hospital complications, decrease in pneumonia, poor swallow function, gastrointestinal bleeding, and deep vein thrombosis (DVT) were significantly associated with higher UA levels compared to Q1 (P for trend < 0.0001).Conclusions: UA was a protective factor for stroke severity and in-hospital complications such as pneumonia, poor swallow function, gastrointestinal bleeding, and DVT. However, no significant evidence indicated that UA levels were predictive of the discharge disposition and in-hospital mortality after ICH.https://www.frontiersin.org/articles/10.3389/fneur.2020.609938/fulluric acidintracerebral hemorrhageseveritymortalitycomplication |
| spellingShingle | Xinmin Liu Xinmin Liu Zhentang Cao Zhentang Cao Hongqiu Gu Hongqiu Gu Hongqiu Gu Hongqiu Gu Kaixuan Yang Kaixuan Yang Kaixuan Yang Kaixuan Yang Ruijun Ji Ruijun Ji Ruijun Ji Ruijun Ji Zixiao Li Zixiao Li Zixiao Li Zixiao Li Xingquan Zhao Xingquan Zhao Xingquan Zhao Xingquan Zhao Yongjun Wang Yongjun Wang Yongjun Wang Yongjun Wang Uric Acid and Clinical Outcomes Among Intracerebral Hemorrhage Patients: Results From the China Stroke Center Alliance Frontiers in Neurology uric acid intracerebral hemorrhage severity mortality complication |
| title | Uric Acid and Clinical Outcomes Among Intracerebral Hemorrhage Patients: Results From the China Stroke Center Alliance |
| title_full | Uric Acid and Clinical Outcomes Among Intracerebral Hemorrhage Patients: Results From the China Stroke Center Alliance |
| title_fullStr | Uric Acid and Clinical Outcomes Among Intracerebral Hemorrhage Patients: Results From the China Stroke Center Alliance |
| title_full_unstemmed | Uric Acid and Clinical Outcomes Among Intracerebral Hemorrhage Patients: Results From the China Stroke Center Alliance |
| title_short | Uric Acid and Clinical Outcomes Among Intracerebral Hemorrhage Patients: Results From the China Stroke Center Alliance |
| title_sort | uric acid and clinical outcomes among intracerebral hemorrhage patients results from the china stroke center alliance |
| topic | uric acid intracerebral hemorrhage severity mortality complication |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2020.609938/full |
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