Admission Uric Acid, Troponin, and C-Reactive Protein Levels and In-Hospital Mortality in Acute Stroke Patients

Stroke remains a leading cause of in-hospital mortality worldwide. Routinely available laboratory biomarkers obtained at emergency department admission may facilitate early risk stratification. This study aimed to evaluate the associations between admission serum uric acid (SUA), troponin, and C-reactive protein (CRP) levels and in-hospital mortality in patients with acute stroke.

This retrospective single-center study included 403 adults diagnosed with acute ischemic or hemorrhagic stroke between January 1, 2019, and January 1, 2022. Demographic data, comorbidities, and admission laboratory findings were extracted from electronic hospital records. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of in-hospital mortality. Receiver operating characteristic (ROC) analysis was used to evaluate discriminatory performance.

Of 403 patients (mean age 73.8 ± 12.4 years; 54.8% male), 16.6% (n=67) died during hospitalization. Non-survivors were significantly older and had higher admission SUA, troponin, and CRP levels (all p<0.001). In multivariable analysis, advanced age (OR: 1.07; 95% CI: 1.03-1.08; p=0.007), troponin >14 ng/L (OR: 2.23; 95% CI: 1.21-4.01; p=0.012), CRP >5 mg/L (OR: 2.93; 95% CI: 1.59-5.67; p=0.001), and SUA >7 mg/dL (OR: 1.93; 95% CI: 1.04-3.53; p=0.041) were independently associated with in-hospital mortality. CRP showed the highest discriminatory performance (AUC: 0.77), while troponin (AUC: 0.67) and SUA (AUC: 0.66) demonstrated limited discriminatory ability.

Admission CRP, troponin, and SUA levels were independently associated with in-hospital mortality in acute stroke patients. However, given their moderate discriminatory performance and the absence of standardized stroke severity scores, these biomarkers should be interpreted as supplementary risk indicators rather than standalone prognostic tools. Prospective multicenter studies incorporating stroke severity scales are warranted.