Background: The relationship between serum uric acid levels and the prognosis of acute stroke and Traumatic Brain Injury (TBI) is not clear. We investigated the value of serum uric acid levels for predicting poor neurological outcomes of acute stroke and traumatic brain injury.
Methods: 140 patients with acute ischemic stroke and Traumatic Brain Injury (TBI) were admitted to hospital and levels of serum uric acid (μmol/L) were determined from venous blood within 24 h. Clinical data was analysed by logistic regression and Receiver Operating Characteristic (ROC) curves. Patients were monitored after 180-day discharge and grouped as unfavorable or favorable based on Glasgow Outcome Scale (GOS) scores.
Results: There was a significant difference in serum uric acid (285 (range 196 to 362) vs. 185 (range 120 to 258), p=0.0001) between unfavorable and favorable groups, respectively. Uric acid was determined to be an independent predictor for poor neurological outcomes of acute stroke and TBI. After adjusting for age and Glasgow Coma Scale (GCS) score, the Odds Ratio (OR) for uric acid was 1.005 (95% CI: 1.0002-1.0101, p=0.039). The area under the ROC curve for serum uric acid was 0.714 (95% CI: 0.632-0.787). The optimal cut-off value of serum uric acid determined by the maximum Youden index was 265 μmol/L (sensitivity 55.4%, specificity 82.1%). ROC analysis showed that the positive predictive value of serum uric acid was 88.9% while the negative one was 41.6%.
Conclusions: The observations suggest that serum uric acid levels could be used as an independent predictor of poor outcome following acute stroke or TBI.