Serum uric acid and acute stroke outcome in Nigerian Africans

Abstract

Background : Serum uric acid (SUA) has long been recognized as a potent antioxidant in plasma and increasingly its prognostic value and therapeutic role in acute stroke has been proven in different population groups. Aim: To assess the role of admission SUA in acute stroke outcome in a Nigerian population. Setting: A tertiary neurologic care center in Nigeria. Design: Prospective observational study. Materials and Methods: Total 240 acute stroke patients aged 30-91 years with first-ever stroke had their blood samples taken consecutively for SUA and blood sugar within 48 hours of onset of stroke symptoms. All were followed-up for outcome within 42 days from the date of admission. Outcome was either discharged to follow-up and still in care or in-hospital death. Stroke subtypes were defined by cranial computed tomography (CT) scan; stroke severity was assessed by the admission Glasgow coma scale (GCS). Statistics: Age, sex, SUA, blood sugar and GCS were compared between the stroke outcome groups. SUA and stroke outcome was tested on simple logistic regression after adjustment for age above 60 years and elevated blood sugar above 200 mg/dl. The contribution of SUA, blood sugar, age, stroke subtype and GCS to time of all cause in-hospital mortality was tested on Cox regression. Results: 1) Mean SUA, age and blood sugar were higher and mean GCS was lower in the deceased group (P < 0.001, 0.001, 0.001 and 0.001). 2) SUA predicted poorer outcome of acute stroke after adjustment for age above 60 years and blood glucose level above 200 mg/dl (P = 0.045, n = 96). 3) SUA, blood glucose and age predicted time to in-hospital mortality (P < 0.001, 0.047, <0.001). Conclusion: SUA predicts poorer outcome and time to all cause in-hospital mortality in acute stroke and may also become a reliable surrogate of acute stroke outcome in Africans as shown in other populations.