The change in serum uric acid during hospitalization predicts short-term prognosis in patients with acute ischemic stroke: a retrospective cohort study

Uric acid, the end product of purine metabolism, acts as a major endogenous antioxidant. However, its prognostic significance in acute ischemic stroke remains controversial. This study aimed to investigate the relationship between serum uric acid (sUA) levels and short-term outcomes in patients with acute ischemic stroke. This retrospective cohort study enrolled patients diagnosed with acute ischemic stroke. Short-term prognosis was assessed at three months post-stroke using the modified Rankin Scale (mRS). sUA levels were measured at admission and again before discharge, and ΔsUA was defined as the pre-discharge sUA minus the sUA at admission. For continuous short-term outcomes, associations with sUA were assessed using univariate linear regression; for binary short-term outcomes, associations were assessed using univariate binary logistic regression. From January 2016 to December 2020, we enrolled 555 patients with acute ischemic stroke. The mean (SD) age of this cohort was 72.9 (13.1) years, and 345 (62.2%) were male. A total of 235 patients experienced poor outcomes at 3 months after stroke. Baseline sUA levels did not differ between those with good and poor outcomes. Nevertheless, the change in sUA (ΔsUA) was significantly greater in the good outcome group [-44.9 (-91.0 to -7.0)µmol/L] than in the poor outcome group [-96.0 (-166.2 to -40.5)µmol/L]. Binary logistic regression models revealed that ΔsUA was independently associated with 3-month prognosis in acute ischemic stroke patients. The change in sUA during hospitalization is a significant predictor of 3-month prognosis in patients with acute ischemic stroke and may serve as a valuable marker for risk stratification and guiding subsequent interventions.