机构：[1]Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China[2]The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia[3]Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China[4]Department of Neurology, Taicang First People’s Hospital, Suzhou, China[5]Department of Neurology, Changshu Second People’s Hospital, Suzhou, China[6]Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Suzhou, China[7]Department of Neurology, Suzhou Xiangcheng People’s Hospital, Suzhou, China[8]Institutes of Neuroscience, Soochow University, Suzhou, China
Background: Prior studies have shown an association between high blood urea nitrogen (BUN) and an elevated risk of mortality in heart failure patients, but data on the prognostic significance of BUN and other markers of kidney function in acute ischemic stroke (AIS) patients are sparse. Methods and Results: A total of 3,355 AIS patients were enrolled from December 2013 to May 2014, across 22 hospitals. Admission BUN was divided into quartiles (Q1, <4.39 mmol/L; Q2, >= 4.39 and <5.40 mmol/L; Q3, >= 5.40 and <6.70 mmol/L and Q4, >= 6.70 mmol/L) and estimated glomerular filtration rate (eGFR), creatinine (Cr) and BUN/Cr were also categorized. Cox proportional hazard and logistic regression models were used to estimate the effect of BUN, eGFR, Cr and BUN/Cr on all-cause in-hospital mortality and poor outcome on discharge (modified Rankin Scale score >= 3) in AIS patients. During hospitalization, 120 patients (3.6%) died from all causes and 1,287 (38.4%) had poor outcome at discharge. BUN was independently associated with all-cause in-hospital mortality (adjusted HR for Q4 vs. Q1, 3.75; 95% CI: 1.53-9.21; P-trend=0.003) but not poor outcome at discharge (P-trend=0.229). No significant association was found, however, between reduced eGFR, increased Cr and BUN/Cr and all-cause in-hospital mortality and poor outcome at discharge (all P-trend >= 0.169). Conclusions: Increased BUN at admission is a significant prognostic factor associated with in-hospital mortality in AIS patients, but not with poor discharge outcome.
基金：
This
work was supported in part by grants from the National Natural
Science Foundation of China (81471195), Suzhou Clinical Research
Center of Neurological Disease (Szzx201503) and Jiangsu Provincial
Medical Key Discipline Project, Second Affiliated Hospital of
Soochow University Preponderant Clinic Discipline Group Project
Funding (XKQ2015002).
第一作者机构：[1]Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
共同第一作者：
通讯作者：
通讯机构：[*1]Department of Neurology, Second Affiliated Hospital of Soochow University, No.1055, Sanxiang Road, 215004, Suzhou, Jiangsu Province of China[*2]Department of Neurology, Second Affiliated Hospital of Soochow University, Suzhou City, Jiangsu 215004, China.
推荐引用方式(GB/T 7714)：
Shoujiang You,Danni Zheng,Chongke Zhong,et al.Prognostic Significance of Blood Urea Nitrogen in Acute Ischemic Stroke[J].CIRCULATION JOURNAL.2018,82(2):572-578.doi:10.1253/circj.CJ-17-0485.
APA：
Shoujiang You,Danni Zheng,Chongke Zhong,Xianhui Wang,Weiting Tang...&Chun-Feng Liu.(2018).Prognostic Significance of Blood Urea Nitrogen in Acute Ischemic Stroke.CIRCULATION JOURNAL,82,(2)
MLA：
Shoujiang You,et al."Prognostic Significance of Blood Urea Nitrogen in Acute Ischemic Stroke".CIRCULATION JOURNAL 82..2(2018):572-578
