Abstract：
BACKGROUND: Hydration plays a critical role in the pathophysiological progression of ischemic stroke. However, the impact of extreme hydration on the mortality of critically ill patients with ischemic stroke remains unclear. Therefore, our objective was to evaluate the association between hydration, as indicated by the blood urea nitrogen to creatinine ratio (UCR), and in-hospital mortality in critically ill patients with ischemic stroke.
METHODS: Data from the Medical Information Mart for Intensive Care (MIMIC-IV) database were utilized. Patients with ischemic stroke admitted to the Intensive Care Unit (ICU) for the first time were identified. The exposure variable was the hydration state represented by the UCR. The study outcome measure was in-hospital mortality. The primary analytical approach involved multivariate Cox regression analysis. Kaplan-Meier curves were constructed, and subgroup analyses with interaction were performed.
RESULTS: A total of 1539 patients, with a mean age of 69.9 years, were included in the study. Kaplan-Meier curves illustrated that patients in higher UCR tertiles exhibited increased in-hospital mortality. Accordingly, the risk of in-hospital mortality significantly rose by 29 % with every 10 units increase in UCR. Subgroup analysis indicated a robust association between UCR and in-hospital mortality in each subgroup, with no statistically significant interactions observed.
CONCLUSIONS: Hydration status is significantly associated with in-hospital all-cause mortality in critically ill patients with ischemic stroke. This finding underscores the importance of closely monitoring critically ill patients for adequate hydration and implementing appropriate rehydration strategies.
METHODS: Data from the Medical Information Mart for Intensive Care (MIMIC-IV) database were utilized. Patients with ischemic stroke admitted to the Intensive Care Unit (ICU) for the first time were identified. The exposure variable was the hydration state represented by the UCR. The study outcome measure was in-hospital mortality. The primary analytical approach involved multivariate Cox regression analysis. Kaplan-Meier curves were constructed, and subgroup analyses with interaction were performed.
RESULTS: A total of 1539 patients, with a mean age of 69.9 years, were included in the study. Kaplan-Meier curves illustrated that patients in higher UCR tertiles exhibited increased in-hospital mortality. Accordingly, the risk of in-hospital mortality significantly rose by 29 % with every 10 units increase in UCR. Subgroup analysis indicated a robust association between UCR and in-hospital mortality in each subgroup, with no statistically significant interactions observed.
CONCLUSIONS: Hydration status is significantly associated with in-hospital all-cause mortality in critically ill patients with ischemic stroke. This finding underscores the importance of closely monitoring critically ill patients for adequate hydration and implementing appropriate rehydration strategies.
摘要：
背景：水合作用在缺血性卒中的病理生理进程中起着至关重要的作用。然而,极度水化对缺血性卒中危重患者死亡率的影响尚不清楚.因此,我们的目标是评估水合之间的关联，如血尿素氮与肌酐之比（UCR）所示，和缺血性卒中危重患者的院内死亡率。
方法：使用来自重症监护医疗信息集市（MIMIC-IV）数据库的数据。首次进入重症监护病房（ICU）的缺血性卒中患者被确定。暴露变量是由UCR表示的水合状态。研究结果测量为院内死亡率。主要分析方法涉及多变量Cox回归分析。构造了卡普兰-迈耶曲线，和亚组分析与相互作用进行。
结果：共1539名患者，平均年龄69.9岁,包括在研究中。Kaplan-Meier曲线表明，UCR较高的患者住院死亡率增加。因此，随着UCR每增加10个单位,院内死亡风险显著增加29%.亚组分析表明，每个亚组的UCR和院内死亡率之间存在密切的关联，没有观察到统计学上显著的相互作用。
结论：在缺血性卒中危重患者中，水化状态与院内全因死亡率显著相关。这一发现强调了密切监测危重患者是否有足够的水合作用并实施适当的补液策略的重要性。
方法：使用来自重症监护医疗信息集市（MIMIC-IV）数据库的数据。首次进入重症监护病房（ICU）的缺血性卒中患者被确定。暴露变量是由UCR表示的水合状态。研究结果测量为院内死亡率。主要分析方法涉及多变量Cox回归分析。构造了卡普兰-迈耶曲线，和亚组分析与相互作用进行。
结果：共1539名患者，平均年龄69.9岁,包括在研究中。Kaplan-Meier曲线表明，UCR较高的患者住院死亡率增加。因此，随着UCR每增加10个单位,院内死亡风险显著增加29%.亚组分析表明，每个亚组的UCR和院内死亡率之间存在密切的关联，没有观察到统计学上显著的相互作用。
结论：在缺血性卒中危重患者中，水化状态与院内全因死亡率显著相关。这一发现强调了密切监测危重患者是否有足够的水合作用并实施适当的补液策略的重要性。
