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Serum creatinine: an independent predictor of survival after stroke
1Stroke Unit, Waikato Hospital, Hamilton, New Zealand.
Insights
Elevated serum creatinine levels independently predict mortality in elderly stroke patients. This finding highlights serum creatinine as a crucial prognostic marker for survival after a stroke event.
Area of Science:
- Nephrology
- Neurology
- Geriatrics
Background:
- Serum creatinine is a marker of kidney function.
- Stroke is a leading cause of mortality in the elderly.
- Predictors of survival after stroke are crucial for patient management.
Purpose of the Study:
- To investigate the relationship between serum creatinine and survival in elderly stroke patients.
- To determine if serum creatinine is an independent predictor of mortality post-stroke.
Main Methods:
- Prospective study of 492 elderly subjects admitted for stroke.
- Multivariate proportional hazards models were used for analysis.
- Patients were monitored for a mean of 18 months post-stroke.
Main Results:
- Serum creatinine was an independent predictor of mortality (P = 0.0001).
- This association persisted after adjusting for numerous clinical factors.
- The relationship was observed in subgroups with ischemic and hemorrhagic stroke.
Conclusions:
- Serum creatinine is an independent predictor of survival after stroke.
- Elevated serum creatinine may indicate increased mortality risk in stroke survivors.
- Further research is needed to understand the mechanisms underlying this association.
Abstract:
We prospectively studied the relationship between serum creatinine and survival among 492 elderly subjects admitted for stroke and monitored for a mean period of 18 months post-stroke. In multivariate proportional hazards models, serum creatinine remained an independent predictor of mortality (P = 0.0001) after accounting for other important predictors such as level of consciousness. Mini-Mental State Score, age, leucocyte count, presence of heart disease, diabetes, heart failure, atrial fibrillation and use of cardiovascular medication. This association between elevated serum creatinine and mortality was also found in patient subgroups with CT-proven infarction and intracerebral haematoma. It is concluded that serum creatinine is an independent predictor of survival after stroke. Further studies are required to confirm this relationship and to elucidate the underlying mechanism.