• Chung-Jen Lin, Yen-Yun Tsai, Kuang-Yu Hsiao, Yuan-Hsiung Tsai, Ming-Hsueh Lee, Yen-Chu Huang, Meng Lee, Jen-Tsung Yang, Cheng-Ting Hsiao, and Leng-Chieh Lin.
• Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. Electronic address: a3456711@ms65.hinet.net.
• J Stroke Cerebrovasc Dis. 2017 Sep 1; 26 (9): 1885-1891.

BackgroundEarly neurological deterioration after ischemic stroke (stroke-in-evolution [SIE]) is associated with poorer outcomes. Previous studies have demonstrated a link between hydration status and the development of SIE. In this study, we tested the hypothesis that rehydration therapy, administered on the basis of urine-specific gravity (USG) findings, might reduce the development of SIE.MethodsWe conducted a single-arm prospective study of patients with acute ischemic stroke with historical controls. For the study group, a USG higher than 1.010 was taken as an indication for rehydration. Control group patients were rehydrated without referring to USG. An increase in National Institutes of Health Stroke Scale (NIHSS) score of 4 or higher within 3 days was defined as having SIE.ResultsA total of 445 patients were analyzed, 167 in the study group and 278 in the control group. The proportion of patients who developed SIE was numerically, but not significantly, lower in the study group (5.9%; 10 of 167) compared with the control group (11.5%; 32 of 278). Among patients with a USG higher than 1.010 at admission, the SIE rate was significantly reduced in the study group compared with the control group (6.1% versus 16.0%; P = .021), while the rate of SIE was similar in those with a USG of 1.010 or lower at admission. Multivariate logistic regression analysis confirmed that USG-based hydration was an independent factor associated with reducing SIE.ConclusionsUSG might be a convenient and useful method for guiding fluid therapy in patients with acute ischemic stroke. USG-based hydration reduced the incidence of SIE among patients with a USG higher than 1.010 at admission.Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

40 keywords...

hide…