Association between blood urea nitrogen to creatinine ratio and 3-month outcome in patients with acute ischaemic stroke: a retrospective cohort study from a large healthcare system

Objectives The blood urea nitrogen to creatinine (BUN/Cr) ratio is associated with early neurological deterioration in acute ischaemic stroke (AIS). However, the predictive value of the BUN/Cr ratio for the AIS prognosis remains unclear. Therefore, we evaluated the correlation between the BUN/Cr rat...

Full description

Saved in:
Bibliographic Details
Main Authors: Hui Li, Mingquan Li, Lina Wang, Ling Liu, Yanli Zhang, Liumin Wang, Xinmei Zhu, Boluo Jia, Wen Xie
Format: Article
Language:English
Published: BMJ Publishing Group 2024-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/7/e085912.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850087482186530816
author Hui Li
Mingquan Li
Lina Wang
Ling Liu
Yanli Zhang
Liumin Wang
Xinmei Zhu
Boluo Jia
Wen Xie
author_facet Hui Li
Mingquan Li
Lina Wang
Ling Liu
Yanli Zhang
Liumin Wang
Xinmei Zhu
Boluo Jia
Wen Xie
author_sort Hui Li
collection DOAJ
description Objectives The blood urea nitrogen to creatinine (BUN/Cr) ratio is associated with early neurological deterioration in acute ischaemic stroke (AIS). However, the predictive value of the BUN/Cr ratio for the AIS prognosis remains unclear. Therefore, we evaluated the correlation between the BUN/Cr ratio and the 3-month outcome in patients with AIS, further testing their dose–response relationship.Design This retrospective cohort study enrolled patients with AIS who were admitted between 1 January 2013 and 31 May 2022. Poor clinical outcome was defined as 3-month Modified Rankin Scale (mRS) >2. Cox proportional HR was used to evaluate the correlation between the BUN/Cr ratio and 3-month outcome. Restricted cubic spline and robust locally weighted regression analyses were conducted to determine the dose–response relationship between the BUN/Cr ratio and the 3-month outcome.Results A total of 4952 eligible patients were included in the study. The patients were divided into three groups according to the tertiles of BUN/Cr ratio (T1, <0.071; T2, 0.071–0.093; and T3, >0.093). After logistic regression adjustment for demographic and clinical characteristics, the BUN/Cr ratio was found to be independently associated with the 3-month outcome in patients with AIS. The restricted cubic spline and locally regression smoothing scatterplot graph showed a strong dose–response relationship between the BUN/Cr ratio and the 3-month outcome in patients with AIS.Conclusion A dose–response relationship was observed between the BUN/Cr ratio and the 3-month outcome in patients with AIS, suggesting that the BUN/Cr ratio could serve as a reliable predictor for the AIS prognosis.
format Article
id doaj-art-8f50e09d29fe40a8b215b7e3b3fe98c0
institution DOAJ
issn 2044-6055
language English
publishDate 2024-07-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-8f50e09d29fe40a8b215b7e3b3fe98c02025-08-20T02:43:12ZengBMJ Publishing GroupBMJ Open2044-60552024-07-0114710.1136/bmjopen-2024-085912Association between blood urea nitrogen to creatinine ratio and 3-month outcome in patients with acute ischaemic stroke: a retrospective cohort study from a large healthcare systemHui Li0Mingquan Li1Lina Wang2Ling Liu3Yanli Zhang4Liumin Wang5Xinmei Zhu6Boluo Jia7Wen Xie82Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Neurology, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaSchool of Medicine, Huzhou University, Huzhou Central Hospital, Huzhou, Zhejiang, ChinaChongqing Medical University, Chongqing, ChinaDepartment of Neurology, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of Neurology, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of Neurology, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaNanjing Qixia District Xigang Community Health Service Center, Nanjing, China3 Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaObjectives The blood urea nitrogen to creatinine (BUN/Cr) ratio is associated with early neurological deterioration in acute ischaemic stroke (AIS). However, the predictive value of the BUN/Cr ratio for the AIS prognosis remains unclear. Therefore, we evaluated the correlation between the BUN/Cr ratio and the 3-month outcome in patients with AIS, further testing their dose–response relationship.Design This retrospective cohort study enrolled patients with AIS who were admitted between 1 January 2013 and 31 May 2022. Poor clinical outcome was defined as 3-month Modified Rankin Scale (mRS) >2. Cox proportional HR was used to evaluate the correlation between the BUN/Cr ratio and 3-month outcome. Restricted cubic spline and robust locally weighted regression analyses were conducted to determine the dose–response relationship between the BUN/Cr ratio and the 3-month outcome.Results A total of 4952 eligible patients were included in the study. The patients were divided into three groups according to the tertiles of BUN/Cr ratio (T1, <0.071; T2, 0.071–0.093; and T3, >0.093). After logistic regression adjustment for demographic and clinical characteristics, the BUN/Cr ratio was found to be independently associated with the 3-month outcome in patients with AIS. The restricted cubic spline and locally regression smoothing scatterplot graph showed a strong dose–response relationship between the BUN/Cr ratio and the 3-month outcome in patients with AIS.Conclusion A dose–response relationship was observed between the BUN/Cr ratio and the 3-month outcome in patients with AIS, suggesting that the BUN/Cr ratio could serve as a reliable predictor for the AIS prognosis.https://bmjopen.bmj.com/content/14/7/e085912.full
spellingShingle Hui Li
Mingquan Li
Lina Wang
Ling Liu
Yanli Zhang
Liumin Wang
Xinmei Zhu
Boluo Jia
Wen Xie
Association between blood urea nitrogen to creatinine ratio and 3-month outcome in patients with acute ischaemic stroke: a retrospective cohort study from a large healthcare system
BMJ Open
title Association between blood urea nitrogen to creatinine ratio and 3-month outcome in patients with acute ischaemic stroke: a retrospective cohort study from a large healthcare system
title_full Association between blood urea nitrogen to creatinine ratio and 3-month outcome in patients with acute ischaemic stroke: a retrospective cohort study from a large healthcare system
title_fullStr Association between blood urea nitrogen to creatinine ratio and 3-month outcome in patients with acute ischaemic stroke: a retrospective cohort study from a large healthcare system
title_full_unstemmed Association between blood urea nitrogen to creatinine ratio and 3-month outcome in patients with acute ischaemic stroke: a retrospective cohort study from a large healthcare system
title_short Association between blood urea nitrogen to creatinine ratio and 3-month outcome in patients with acute ischaemic stroke: a retrospective cohort study from a large healthcare system
title_sort association between blood urea nitrogen to creatinine ratio and 3 month outcome in patients with acute ischaemic stroke a retrospective cohort study from a large healthcare system
url https://bmjopen.bmj.com/content/14/7/e085912.full
work_keys_str_mv AT huili associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem
AT mingquanli associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem
AT linawang associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem
AT lingliu associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem
AT yanlizhang associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem
AT liuminwang associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem
AT xinmeizhu associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem
AT boluojia associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem
AT wenxie associationbetweenbloodureanitrogentocreatinineratioand3monthoutcomeinpatientswithacuteischaemicstrokearetrospectivecohortstudyfromalargehealthcaresystem