Prognostic significance of urinary protein and urinary ketone bodies in acute ischemic stroke |
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| Affiliation: | 1. Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China;2. Department of Neurology, Changshu TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215000, China;3. Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China;4. Department of Neurology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, China;5. Institutes of Neuroscience, Soochow University, Suzhou, 215123, China;1. Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico;2. Departamento de Fisiología de la Nutrición, Mexico;3. División de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico;4. Facultad de Enfermería, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico;5. Instituto Nacional de Medicina Génomica, Ciudad de México, Mexico;6. Département de Biochimie et Médecine Moléculaire, Université de Montréal, Montréal, QC, Canada;7. Maisonneuve-Rosemont Hospital Research Centre, Montréal, QC, Canada;8. Instituto Nacional de Pediatría, Ciudad de México, Mexico;9. Centro de Salud Universitario, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico;10. Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA;11. IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain;1. Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China;2. Children Heart Center, Sichuan Provincial Maternity and Child Health Care Hospital, 290 Shayan West Second Street, 610000 Chengdu, Sichuan Province, China;3. Ministry of Education-Shanghai Key Laboratory of Children''s Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China;4. Clinical Research Unit, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China;1. Department of Epidemiology & Data Science, Amsterdam UMC-location VUmc, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, the Netherlands;2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands;3. Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands;4. Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands;5. Department of Nephrology, Amsterdam UMC-location VUmc, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, the Netherlands |
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| Abstract: | Background and aimsPrior studies have shown an association between positive urinary protein and an elevated risk of long-term mortality in patients with acute ischemic stroke (AIS); however, data on the short-term prognostic significance of urinary protein and urinary ketone bodies in patients with AIS is sparse.Methods and resultsA total of 2842 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. Patients were divided into urinary protein positive and negative, urinary ketone bodies positive and negative by urine dipstick. Cox and logistic regression models were used to estimate the effect of urinary protein and urinary ketone bodies on all cause in-hospital mortality and poor outcome upon discharge (modified Rankin Scale score ≥3) in AIS patients. Patients with positive urinary protein was associated with a 2.74-fold and 1.62-fold increase in the risk of in-hospital mortality (adjusted HR 2.74; 95% CI, 1.54–4.89; P-value = 0.001) and poor outcome upon discharge (aOR, 1.62; 95% CI 1.26–2.08; P-value <0.001) in comparison to negative urinary protein after adjusting for potential covariates. Moreover, Patients with positive urinary ketone bodies was associated with 2.11-fold in the risk of poor outcome upon discharge (aOR 2.11; 95% CI 1.52–2.94; P-value <0.001) but not in-hospital mortality (P-value = 0.066) after adjusting for potential covariates.ConclusionsUrinary protein at admission was independently associated with in-hospital mortality and poor functional outcome at hospital discharge in acute stroke patients and urinary ketone bodies also associated with poor functional outcome at hospital discharge. |
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| Keywords: | Acute ischemic stroke In-hospital outcomes Urinary protein Urinary ketone bodies |
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