Evaluation of the Association of Serum Uric Acid Levels and Stroke in Emergency Department Patients

Abstract

Aim: Stroke is a leading cause of disability and fatality. While clinical and imaging methods are commonly used in stroke management, biochemical parameters such as serum uric acid (SUA) level are largely overlooked. This study aimed to examine the relationship between high or low SUA levels and both ischemic and hemorrhagic stroke. Material and Methods: This is a retrospective, single-center observational study. The study included all consecutive patients who were consulted from the emergency department (ED) to neurology and/or neurosurgery between January 1, 2023, and December 31, 2023. Data of the patients were obtained from the hospital computer system and ED records. While SUA levels of ≤2.8 mg/dL indicated hypouricemia, levels of ≥7 mg/dL were considered hyperuricemia. Results: A total of 1186 adult patients were included in the study. It was observed that 484 of them were diagnosed with stroke, 394 were ischemic stroke, and 90 were hemorrhagic stroke. Stroke patients had higher median SUA levels (p<0.001). The median SUA level of ischemic stroke patients was higher than hemorrhagic stroke patients (p<0.001). Hyperuricemia increased the risk of ischemic stroke 2.4-fold (OR: 2.402, 95% CI: 1.792-3.221, p<0.001). Hypouricemia decreased the risk of ischemic stroke (OR: 0.272, 95% CI: 0.129-0.577, p<0.001). Conclusion: SUA levels are associated with stroke and ischemic stroke. Hyperuricemia may be useful as an additional parameter to strengthen the diagnosis of possible stroke in ED. SUA levels of patients at risk for stroke can be useful in terms of follow-up of these patients and the precautions to be planned.

Keywords

• Emergency Department
• Stroke
• Uric Acid

Acil Servis Hastalarında Serum Ürik Asit Düzeyi ve İnme İlişkisinin Değerlendirilmesi

Öz

Amaç: İnme, sakatlık ve ölümlerin önde gelen nedenlerinden biridir. İnme yönetiminde klinik ve görüntüleme yöntemleri yaygın olarak kullanılırken, serum ürik asit (SUA) düzeyi gibi biyokimyasal parametreler büyük ölçüde göz ardı edilmektedir. Bu çalışmada, yüksek veya düşük SUA düzeyleri ile hem iskemik hem de hemorajik inme arasındaki ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma retrospektif, tek merkezli gözlemsel bir çalışmadır. Çalışmaya 1 Ocak 2023 ile 31 Aralık 2023 tarihleri arasında acil servisten nöroloji ve/veya beyin cerrahisine konsülte edilen tüm ardışık hastalar dahil edilmiştir. Hastaların verileri hastane bilgisayar sisteminden ve acil servis kayıtlarından elde edilmiştir. ≤2,8 mg/dL olan SUA düzeyleri hipoürisemiyi gösterirken, ≥7 mg/dL olması hiperürisemi olarak kabul edildi. Bulgular: Çalışmaya toplam 1186 yetişkin hasta dahil edildi. Bunların 484'ünün inme tanısı aldığı, 394'ünün iskemik inme, 90'ının ise hemorajik inme olduğu görüldü. İnme hastalarının medyan SUA düzeyleri daha yüksekti (p<0,001). İskemik inme hastalarının medyan SUA düzeyi hemorajik inme hastalarından daha yüksekti (p<0,001). Hiperürisemi iskemik inme riskini 2,4 kat artırmıştır (OR: 2,402; %95 GA: 1,792-3,221; p<0,001). Hipoürisemi iskemik inme riskini azaltmıştır (OR: 0,272; %95 GA: 0,129-0,577; p<0,001). Sonuç: SUA düzeyleri inme ve iskemik inme ile ilişkilidir. Hiperürisemi, acil serviste olası inme tanısını güçlendiren ek bir parametre olarak yararlı olabilir. İnme açısından riskli hastaların SUA düzeyleri bu hastaların takibi ve planlanacak önlemler açısından faydalı olabilir.

Anahtar Kelimeler

• Acil Servis
• inme
• Ürik Asit

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