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Background: Only a few clinical research had previously investigated the dehydration status to predict the evolution of the ischemic core. The aim of this study is to clarify the association between blood urea nitrogen (BUN)/creatinine (Cr)ratio-based dehydration and infarct volume measured using DWI (Diffusion-weighted imaging) at admission in patients with AIS (Acute Ischemic Stroke).

Methods: We retrospectively recruited a total of 203 consecutive patients who were hospitalized through emergency or outpatient services within 72 h of acute ischemic stroke onset between October 2015 and September 2019. Stroke severity was measured by assessing the National Institutes of Health Stroke Scale (NIHSS) on admission. Infarct volume was measured using DWI with MATLAB software.

Results: In this study, 203 patients who met the study criteria were enrolled. Patients in the dehydration group (Bun/Cr ratio>15) had a higher median NIHSS score (6(IQR:4-10) VS. 5(3-7); P = 0.0015)and larger DWI infarct volume (1.55 ml (IQR:0.51-6.79) VS. (0.37 ml (0.05-1.22); P < 0.001) on admission compared with patients in normal group. Further, a statistically significant correlation was found between DWI infarct volumes and NIHSS score with nonparametric Spearman rank correlation (r = 0.77; P < 0.001). The median NIHSS scores for the DWI infarct volumes quartiles were 3 ml (IQR, 2-4), 5 ml (4-7), 6 ml (5-8), and12 ml (8-17) from lowest to highest. However, the second quartile group did not show any significant correlation with the third quartile group (P = 0.4268). Multivariable linear and logistic regression analyses were used to test dehydration (Bun/Cr ratio>15), representing a predictor of infarct volume and stroke severity.

Conclusion: Bun/Cr ratio-based dehydration is associated with larger volumes of ischemic tissue measured using DWI and worse neurological deficit assessed by the NIHSS score in acute ischemic stroke.

Competing Interests: Conflict of Interest Statement The authors have no conflicts to disclose.

Titel:	Association of Bun/Cr ratio-based dehydration status with infarct volumes and stroke severity in acute ischemic stroke.
Autor/in / Beteiligte Person:	Li, H ; Wang, H ; Fu, Q ; Liu, Y ; Song, B ; Zhao, J ; Lin, J
Zeitschrift:	Clinical neurology and neurosurgery, Jg. 229 (2023-06-01), S. 107741
Veröffentlichung:	Amsterdam : Elsevier ; <i>Original Publication</i>: Assen, Van Gorcum., 2023
Medientyp:	academicJournal
ISSN:	1872-6968 (electronic)
DOI:	10.1016/j.clineuro.2023.107741
Schlagwort:	Humans Blood Urea Nitrogen Retrospective Studies Dehydration diagnostic imaging Dehydration complications Diffusion Magnetic Resonance Imaging methods Infarction complications Severity of Illness Index Ischemic Stroke complications Brain Ischemia complications Brain Ischemia diagnostic imaging Stroke complications
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Clin Neurol Neurosurg] 2023 Jun; Vol. 229, pp. 107741. <i>Date of Electronic Publication: </i>2023 Apr 26. MeSH Terms: Ischemic Stroke* / complications ; Brain Ischemia* / complications ; Brain Ischemia* / diagnostic imaging ; Stroke* / complications ; Humans ; Blood Urea Nitrogen ; Retrospective Studies ; Dehydration / diagnostic imaging ; Dehydration / complications ; Diffusion Magnetic Resonance Imaging / methods ; Infarction / complications ; Severity of Illness Index Contributed Indexing: Keywords: Acute ischemic stroke; DWI; Dehydration; NIHSS; Stroke severity Entry Date(s): Date Created: 20230429 Date Completed: 20230522 Latest Revision: 20230601 Update Code: 20231215

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Association of Bun/Cr ratio-based dehydration status with infarct volumes and stroke severity in acute ischemic stroke.