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The related main theme: A. Stroke and Cerebral vascular disorders

Association Between Dehydration And Early Neurological Deterioration In Acute Ischemic Stroke Patients

Authers:

Ike Retno Yolanda, MD 1 , Alfansuri  Kadri, PhD, MD 1 , Irina Kemala Nasution, MD 1 , 
1 Departemen Neurologi Fakultas Kedokteran Universitas Sumatera Utara
Corresponding Author:

Ike Retno  Yolanda

keywords: dehydration, ischemic stroke, early neurological deterioration
Abstract for original article

OBJECTIVES /BACKGROUND:
Early neurological deterioration (END) is a common complication of ischemic stroke and associated with poor outcome. Dehydration can contribute in acute ischemic stroke, increase cerebral infarction risk, and serve as an independent predictor of END. Blood urea nitrogen (BUN)/creatinine (Cr) ratio, a marker of hydration status, was an independent predictor of END among patients who had suffered acute ischemic stroke. This study aimed to determine the association between dehydration and END in acute ischemic stroke patients.

MATERIAL and METHOD:
This study used a cross sectional design. Sampling was conducted at Adam Malik General Hospital Medan. Samples were taken as many as 40 subjects consecutively. Dehydration was assessed based on BUN/Cr ratio at admission and dehydration indicated by an increased BUN/Cr ratio ≥ 15. Early Neurological Deterioration was assessed using the National Institute of Health Stroke Scale (NIHSS) score at admission and the third day of treatment. Data analysis used fisher’s exact test.

RESULT:
The demographic characteristics subject in this study was 22 female and 18 male with mean age of 60,97±9,77 years. The mean of BUN/Cr ratio was 15,05±6,62. Patients who experienced dehydration was about 11 patients. The NIHSS day 1 score had an average of 9.55±6.73, the NIHSS day 3 score was 11.25±7.93. Most subjects experienced END. Using fisher’s exact test, we found that dehydration can contribute in early neurological deterioration with p = 0.03.

DISCUSSION:
There is a significant relationship between dehydration and END in patients with acute ischemic stroke. An increased of BUN/Cr ratio ≥ 15 at admission was an independent risk factor for END in patients with acute ischemic stroke


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