Prognostic Importance of Serum Uric Acid in Acute Ischaemic Stroke

Introduction : Role of uric acid as a prognostic marker of atherosclerotic vascular diseases has remained a debatable issue. Since information on this aspect from south Asian population is rather scanty, we have evaluated prognostic significance of serum uric acid in acute ischaemic stroke, in an urban hospital of eastern India. Methods : In this prospective observational study, 193 ischaemic stroke patients were evaluated. CT scan was done and other investigations including serum uric acid were measured at admission. Neurological assessment was done by Mathew score both at admission and at discharge. Outcome was categorized as good (Mathew score > 75) or poor (Mathew score </= 75) and analyzed by multiple logistic regression for evaluation of prognostic significance of uric acid. Results : The age of patients (female: male =1:1.3) ranged from 40 years to 86 years (mean = 62.37±10.81). Higher uric acid level was associated with good clinical outcome (OR = 2.20, 95% CI = 1.55 to 3.13, p<0.0001).Other factors found to be predictors of good outcome are higher Mathew Score at admission (OR =1.10, 95% CI = 1.06 to 1.14, p<0.0001) and female sex (OR = 4.90, 95% CI = 1.44 to 16.63, p = 0.01). Factors associated with poor outcome were large infarct size (OR = 0.10, 95% CI = 0.02 to 0.63, p = 0.01), higher serum urea value (OR = 0.95, CI = 0.90 to 0.99, p = 0.02) and presence of atrial fibrillation (OR = 0.06, CI = 0.01 to 0.56, p = 0.01). Conclusion: Higher serum uric acid level was associated with good clinical outcome in acute ischaemic stroke.