Prevalence of hypohydration and its association with stroke severity and independence outcomes in acute ischemic stroke patients. (February 2020)

• Record Type: Journal Article
• Authors: Buoite Stella, Alex; Gaio, Marina; Furlanis, Giovanni; Ridolfi, Mariana; Ajčević, Miloš; Sartori, Arianna; Caruso, Paola; Morrison, Shawnda A.; Naccarato, Marcello; Manganotti, Paolo
• Is Part Of: Journal of clinical neuroscience. Volume 72(2020)
• Page Start: 281
• Page End: 286
• Publication Date: 2020-02
• Subjects: Dehydration -- Cerebrovascular disorders -- Stroke -- Outcome assessment; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2019.11.002
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Hypohydration is associated with worse outcomes after ischemic stroke. Hypohydration should be define by both serum and urine biomarkers. Urine biomarkers better describe chronic low fluid intake and gradual dehydration. Urine osmolality >500 mOsm/kg predicts worse outcomes after acute ischemic stroke. Abstract: Hypohydration has been suggested increasing the risk of vascular diseases, and it is associated with poor prognosis and worse functional outcome in stroke. Most studies have used blood parameters to determine patients' hydration status. The aim of this study was to measure urine osmolality (uOsm) and its influence on stroke severity and independence. A prospective descriptive study was conducted in stroke patients admitted to a stroke unit. All patients underwent neurological evaluation at admission and discharge using the National Institute of Health Stroke Scale (NIHSS). Independence at discharge was evaluated with the Barthel Index (BI) and the modified Rankin Scale (mRS). uOsm was measured at admission. Patients were grouped in "poor fluid intake" (PF) and "euhydration" (EU), the latter if uOsm ≤ 500 mOsm/kg. Among 119 included patients, the prevalence of PF was 52%, with no difference observed between groups in demographics or blood samples analyses. PF had higher chances of NIHSS > 8 at admission (OR: 4.7 95% CI: 1.3–17.0; p = 0.02), lower BI at discharge (β: −15.3 95% CI: −26.7 to −3.8; p = 0.01), and worse mRS at discharge (OR: 4.01 95% CI: 1.2–14.0; p = 0.02). These findings are consistent with previous results, suggesting that uOsm may be a factor significantly associated with stroke severity and independence outcome after acute ischemic stroke.