Elevated urea nitrogen to creatinine ratio during hospitalization is associated with 90-day poor outcome in ICH patients

Background and PurposeDehydration is common in hospitalized patients and associated with poor outcome in ischemic stroke patients. Intracerebral hemorrhage patients use hyperosmolar agents frequently after admission, which may lead to dehydration. Since the blood urea nitrogen to creatinine ratio (BUN/Cr) is an indicator of dehydration, it is unknown whether there is a relationship between BUN/Cr ratio during hospitalization and clinical outcome of intracerebral hemorrhage patients. MehtodsA total of 211 patients with supratentorial cerebral hemorrhage were included. Clinical data was collected retrospectively. BUN/Cr ratio on day 7 after onset (7dBUN/Cr) was calculated. Poor outcome was defined as 90-day mRS>2. Univariate and multivariate logistic regression analyses were used to determine the relationship between 7dBUN/Cr ratio and 90-day poor outcome. Receiver operating curve was used to determine the best cutoff of 7dBUN/Cr ratio for predicting poor outcome. ResultsNIHSS score, hematoma volume and 7dBUN/Cr ratio were independently correlated with 90-day poor outcome. Under receiver operating curve, 7dBUN/Cr ratio exhibited similar prognostic capability, as compared to hematoma volume. The best cutoff for 7dBUN/Cr ratio to predict poor outcome was 22 in the hyperosmolar agents subgroup. ConclusionsElevated BUN/Cr ratio at day 7 is associated with 90-day poor outcome in ICH patients. Further prospective study will be required to confirm this result and explore the value of BUN/Cr ratio in the application of hyperosmolar agents and hydration therapy.