Effects of admission serum urea, glomerular filtration rate, proteinuria and diabetes status on 3-month mortality after acute stroke

Abstract

from hypovolemia, renovascular disease or reduced cardiac output. Our finding from this study predicting short-term mortality is in contrast to the findings from another study which showed that creatinine was a independent predictor of long-term mortality post-stroke. This large well-conducted study looking at biochemical predictors of longterm outcome after stroke however did not include serum urea as a prognostic determinant. Another study has implicated congestive cardiac failure as a mechanism of raisedurea-induced poor outcome. Interestingly, N-Terminal Brain Natriuretic Peptide level, a sensitive marker of cardiac dysfunction, has also been shown to independently predict short-term mortality post-stroke. It is therefore tempting to speculate the presence of underlying occult heart failure in patients with acute stroke and that interventions with pharmacotherapy to target cardiac disorders may confer shortand longer-term benefits. Our study has also shown that diabetes predicts poor stroke outcome, but it remains unclear whether hyperglycaemia is simply a cause or a marker of poor outcome. In conclusion, serum urea and diabetes status independently predict short-term mortality following an acute stroke. These parameters should therefore be included in developing future models of quality and prognosis of post-stroke care in predicting short-term mortality.