Background
Methods
The stroke registry of the Chang Gung healthcare system
Patient recruitment, procedures, and data collection
Statistical analysis
Results
Characteristics of subjects with and without dehydration
Non-dehydration (BUN/Cr < 15) (N = 164) | Dehydration (BUN/Cr ≥ 15) (N = 182) |
p-value | |
---|---|---|---|
Age | 63.39 ± 13.63 | 66.87 ± 12.39 | 0.013*
|
Sex | |||
Female | 41(25%) | 84(46.15%) | <0.001*
|
Male | 123(75%) | 98(53.85%) | |
Length of hospitalization | 12.2(8–20) | 13(8–23) | 0.361 |
BMI (kg/m2) | 24.56 ± 4.23 | 24.03 ± 3.70 | 0.225 |
GCS | 15(11–15) | 15(11–15) | 0.222 |
WBC | 7.9(6.4–10.05) | 7.45(6.3–9.45) | 0.207 |
RBC | 4.72(4.34–5.08) | 4.65(4.29–4.98) | 0.274 |
Hb | 14.18 ± 1.82 | 13.87 ± 1.83 | 0.120 |
Hct | 41.8 ± 4.8 | 41.13 ± 4.56 | 0.192 |
PL | 209(165–247) | 203.5(170–235) | 0.825 |
PT | 10.8(10.3–11.6) | 11(10.4–11.5) | 0.357 |
APTT | 26(24.4–27.9) | 25.65(24.3–27.3) | 0.380 |
ALB | 3.7(3.4–4.09) | 3.78(3.4–4.09) | 0.595 |
LDL | 114.5(95–131) | 110(91–137) | 0.623 |
HDL | 42(36–51) | 42.55(36–51) | 0.474 |
TCHO | 181(159–204) | 178.5(151–208) | 0.366 |
TG | 106.5(81.5–153) | 94(75–137) | 0.038*
|
BUN | 11.2(9–13.8) | 17(14–21.4) | <0.001*
|
UA | 5.71 ± 1.63 | 5.35 ± 1.67 | 0.083 |
AST | 26(20–33) | 27(20–36) | 0.824 |
ALT | 22(17–32) | 23(18–32) | 0.740 |
Cr | 1(0.87–1.2) | 0.87(0.72–1.07) | <0.001*
|
Glucose | 123(100–157) | 130(111–169.5) | 0.035*
|
Hb1 | 5.9(5.6–6.4) | 6(5.7–7.4) | 0.020*
|
CRP | 12.2(4.9–51.2) | 16.97(5.5–61.16) | 0.462 |
Na | 139(137.9–141) | 138.6(137–140) | 0.029*
|
K | 3.69(3.4–3.9) | 3.71(3.53–4) | 0.005*
|
Lymphocyte | 29.68 ± 10.37 | 30.04 ± 12.09 | 0.771 |
SPG | 1.01(1.01–1.02) | 1.02(1.01–1.02) | 0.412 |
SBP | 149.5(136–162) | 146(130–158) | 0.082 |
NIHSS-Entry | 11(7–18) | 12.5(7–18) | 0.898 |
NIHSS-Discharge | 6(2–12.5) | 7(3–15) | 0.106 |
Complication | |||
Infection | |||
No | 120(73.17%) | 123(67.58%) | 0.256 |
Yes | 44(26.83%) | 59(32.42%) | |
Hemorrhage | |||
No | 153(93.29%) | 170(93.41%) | 0.966 |
Yes | 11(6.71%) | 12(6.59%) | |
Gout | |||
No | 151(92.07%) | 175(96.15%) | 0.104 |
Yes | 13(7.93%) | 7(3.85%) | |
Proteinuria | |||
No | 80(57.55%) | 95(60.13%) | 0.653 |
Yes | 59(42.45%) | 63(39.87%) | |
Toast Dx | |||
Cardioembolism | 51(31.1%) | 69(37.91%) | 0.709 |
Lacune | 27(16.46%) | 32(17.58%) | |
Large-artery atherosclerosis | 40(24.39%) | 35(19.23%) | |
Other determined | 1(0.61%) | 2(1.1%) | |
Undetermined | 38(23.17%) | 38(20.88%) | |
Favorable prognosis | |||
mRS ≤ 2 | 64(39.02%) | 48(26.37%) | 0.012*
|
BI ≥60 | 82(50.0%) | 75(41.21%) | 0.101 |
Analysis of prognosis at discharge
mRS | BI | |||||
---|---|---|---|---|---|---|
Variable | Unfavorable prognosis (N = 250) | Favorable prognosis (N = 132) |
p-value | Unfavorable prognosis (N = 198) | Favorable prognosis (N = 184) |
p-value |
Age | 66.62 ± 13.11 | 61.7 ± 12.4 | <0.001*
| 66.84 ± 13.33 | 62.85 ± 12.48 | 0.003*
|
Sex | 0.100 | 0.004*
| ||||
Female | 99(39.6%) | 41(31.06%) | 86(43.43%) | 54(29.35%) | ||
Male | 151(60.4%) | 91(68.94%) | 112(56.57%) | 130(70.65%) | ||
Days of admission | 15.5(9–24) | 9(6.41–13) | <0.001*
| 16.83(10–26) | 9.31(7–14) | <0.001*
|
BMI (kg/m2) | 24.25 ± 3.94 | 24.34 ± 3.96 | 0.837 | 24.33 ± 4.04 | 24.24 ± 3.85 | 0.834 |
GCS | 12.95 ± 2.62 | 13.94 ± 1.94 | <0.001*
| ND | ND | ND |
WBC | 7.6(6.2–9.6) | 8(6.6–10) | 0.109 | ND | ND | ND |
RBC | 4.69(4.32–5) | 4.67(4.29–5.05) | 0.803 | 4.7(4.29–5.01) | 4.68(4.33–5.02) | 0.741 |
Hb | 14.01 ± 1.76 | 14.07 ± 1.92 | 0.771 | ND | ND | ND |
Hct | 41.51 ± 4.53 | 41.45 ± 4.9 | 0.902 | ND | ND | ND |
PL | 198(165–237) | 216(181–254) | 0.012*
| ND | ND | ND |
PT | 10.9(10.3–11.5) | 10.8(10.3–11.4) | 0.198 | 11(10.5–11.7) | 10.7(10.3–11.3) | 0.002*
|
APTT | 25.6(24.3–27.3) | 26.3(24.3–28) | 0.221 | 25.45(24.3–27.2) | 26.1(24.4–27.9) | 0.139 |
ALB | 3.75(3.4–4.09) | 3.79(3.45–4.09) | 0.501 | ND | ND | ND |
LDL | 110(92–131) | 114(95–137) | 0.23 | ND | ND | ND |
HDL | 43.5(37.65–52) | 40(35–51) | 0.064 | ND | ND | ND |
TCHO | 178.5(157–203) | 183(158–206) | 0.353 | ND | ND | ND |
TG | 94.5(74.5–140.5) | 109(83–154) | 0.034*
| ND | ND | ND |
BUN | 14.75(12–20) | 12.05(9.55–16.85) | 0.001*
| ND | ND | ND |
UA | 5.42 ± 1.73 | 5.68 ± 1.49 | 0.187 | ND | ND | ND |
AST | 28(21–37) | 24(19–29) | <0.001*
| ND | ND | ND |
ALT | 23(17–32) | 21(17–30) | 0.133 | ND | ND | ND |
Cr | 0.95(0.8–1.17) | 0.9(0.76–1.1) | 0.125 | ND | ND | ND |
Glucose | 128(109–163) | 119.5(99–148) | 0.032*
| ND | ND | ND |
Hb1 | 6(5.7–6.9) | 5.8(5.6–6.3) | 0.053 | ND | ND | ND |
CRP | 17.1(5.59–61.16) | 9.07(3.09–30.78) | 0.007*
| ND | ND | ND |
Na | 139(137.4–141) | 138.85(137–140) | 0.162 | ND | ND | ND |
K | 3.7(3.5–4) | 3.7(3.31–3.94) | 0.231 | ND | ND | ND |
Segment | 60.76 ± 12.46 | 61.54 ± 12.14 | 0.564 | ND | ND | ND |
Lymphocyte | 30.15 ± 11.56 | 30.05 ± 10.61 | 0.934 | ND | ND | ND |
SPG | 1.02(1.01–1.02) | 1.01(1.01–1.02) | <0.001*
| 1.02(1.01–1.02) | 1.01(1.01–1.02) | <0.001*
|
SBP | 150(133–162) | 143.5(129–157) | 0.031*
| 150(133–162) | 146(130–158) | 0.098 |
NIHSS-Entry | 14(9–19) | 8.5(6–13) | <0.001*
| ND | ND | ND |
NIHSS-Discharge | 10(6–17) | 2(0–4) | <0.001*
| ND | ND | ND |
Complication | ||||||
Infection | <0.001*
| <0.001*
| ||||
No | 156(62.4%) | 119(90.15%) | 116(58.59%) | 159(86.41%) | ||
Yes | 94(37.6%) | 13(9.85%) | 82(41.41%) | 25(13.59%) | ||
Hemorrhage | <0.001*
| 0.004*
| ||||
No | 226(90.4%) | 131(99.24%) | 178(89.9%) | 179(97.28%) | ||
Yes | 24(9.6%) | 1(0.76%) | 20(10.1%) | 5(2.72%) | ||
Gout | 0.378 | 0.973 | ||||
No | 233(93.2%) | 126(95.45%) | 186(93.94%) | 173(94.02%) | ||
Yes | 17(6.8%) | 6(4.55%) | 12(6.06%) | 11(5.98%) | ||
Proteinuria | <0.001*
| <0.001*
| ||||
No | 116(53.21%) | 78(75%) | 82(48.24%) | 112(73.68%) | ||
Yes | 102(46.79%) | 26(25%) | 88(51.76%) | 40(26.32%) | ||
Bun/Cr | 0.012*
| 0.101 | ||||
<15--Non-dehydration | 100(42.74%) | 64(57.14%) | 82(43.39%) | 82(52.23%) | ||
≥15--Dehydration | 134(57.26%) | 48(42.86%) | 107(56.61%) | 75(47.77%) | ||
Toast Dx | 0.001*
| |||||
Cardioembolism | 94(37.6%) | 33(25%) | ND | ND | ||
Lacune | 30(12%) | 39(29.55%) | ND | ND | ||
Large-artery atherosclerosis | 56(22.4%) | 24(18.18%) | ND | ND | ||
Other determined | 3(1.2%) | 1(0.76%) | ND | ND | ||
Undetermined | 57(22.8%) | 30(22.73%) | ND | ND |
Identification of variables associated with prognosis
Variable | OR (95% CI) |
p-value |
---|---|---|
Multivariate analysis after the forward stepwise method | ||
Bun/Cr | ||
< 15--Non-dehydration | ref | |
≥ 15--Dehydration | 0.46(0.27–0.79) | 0.004*
|
PL | 1.003(0.9996–1.01) | 0.079 |
SPG | 1.28 × 10−31 (4.88 × 10−49 - 3.38 × 10−14) | 0.001*
|
Stratified by TOAST | ||
For Cardioembolism | ||
Bun/Cr | ||
< 15--Non-dehydration | ref | |
≥ 15--Dehydration | 0.96(0.37–2.46) | 0.929 |
PL | 0.999(0.99–1.01) | 0.766 |
SPG | 7.71 × 10−25(8.76 × 10−52 - 677.77) | 0.079 |
For Lacune | ||
Bun/Cr | ||
< 15--Non-dehydration | ref | |
≥ 15--Dehydration | 0.24(0.06–1.01) | 0.052 |
PL | 1.02(1.004–1.04) | 0.019*
|
SPG | 9.75 × 10−78(5.11 × 10−163 - 1.86 × 108) | 0.077 |
For Large-artery atherosclerosis | ||
Bun/Cr | ||
< 15--Non-dehydration | ref | |
≥ 15--Dehydration | 0.65(0.20–2.08) | 0.472 |
PL | 1.004(0.997–1.01) | 0.261 |
SPG | 1.38 × 10−25 (9.05 × 10−62 - 2.10 × 1011) | 0.178 |
OR (95% CI) |
p-value | |
---|---|---|
Multivariate analysis after the forward stepwise method | ||
Bun/Cr | ||
< 15--Non-dehydration | ref | |
≥ 15--Dehydration | 0.58(0.35–0.98) | 0.041*
|
Sex | ||
Female | ref | |
Male | 1.59(0.92–2.77) | 0.097 |
Infection | ||
No | ref | |
Yes | 0.34(0.19–0.62) | <0.001*
|
Proteinuria | ||
No | ref | |
Yes | 0.42(0.25–0.71) | 0.001*
|
Stratified by TOAST | ||
For Cardioembolism | ||
Bun/Cr | ||
< 15--Non-dehydration | ref | |
≥ 15--Dehydration | 0.84(0.29–2.41) | 0.743 |
Sex | ||
Female | ref | |
Male | 3.31(1.22–8.98) | 0.019*
|
Infection | ||
No | ref | |
Yes | 0.39(0.13–1.16) | 0.091 |
Proteinuria | ||
No | ref | |
Yes | 0.15(0.05–0.43) | <0.001*
|
For Lacune | ||
Bun/Cr | ||
< 15--Non-dehydration | ref | |
≥ 15--Dehydration | 0.63(0.18–2.18) | 0.470 |
Sex | ||
Female | ref | |
Male | 0.82(0.23–2.93) | 0.755 |
Infection | ||
No | ref | |
Yes | 0.76(0.16–3.48) | 0.720 |
Proteinuria | ||
No | ref | |
Yes | 1.29(0.34–4.92) | 0.708 |
For Large-artery atherosclerosis | ||
Bun/Cr | ||
< 15--Non-dehydration | ref | |
≥ 15--Dehydration | 0.61(0.2–1.91) | 0.397 |
Sex | ||
Female | ref | |
Male | 0.93(0.23–3.8) | 0.914 |
Infection | ||
No | ref | |
Yes | 0.23(0.06–0.92) | 0.038*
|
Proteinuria | ||
No | ref | |
Yes | 1.08(0.31–3.82) | 0.905 |