The Influence of Dehydration on the Outcome of Acute Ischemic Stroke

Objective: Dehydration occurs frequently in patients with acute ischemic stroke (AIS) and theoretically can worsen patient's outcome by decreasing cardiac output and increasing blood viscosity resulting in decreased cerebral blood flow. The aim of this study was to determine whether dehydration worsened clinical and functional outcome of AIS. Methods: A cohort study was performed between October 2016 and April 2017. There were 44 subjects with AIS recruited. Subjects were divided into 2 groups on the basis of blood ureum/creatinine ratio and serum osmolality. Dehydration is defined as ureum/creatinine ratio >= 32,1 or blood osmolality > 310 mOsm/kg at admission day. Outcome was measured with 2 scale: National Institutes of Health Stroke Scale (NIHSS) score difference on admission compared to score at day 7 of hospitalization; and (2) modified Rankin scale (mRS) at day 30 after AIS onset. Results: A total of 44 subjects were enrolled (dehydration, n = 21; control, n = 23). 25 subjects (57%) were male; 4 subjects (9%) had partial anterior circulation infarct (PACI) and 40 subjects (91%) had lacunar infarct (LACI). Dehydration was not associated with either NIHSS worsening (p-value = 0.176) or poor 30-day-mRS (p-value = 1.00). The only variable associated with poor NIHSS and mRS outcome was PACI (p-value 0.003 and 0.001, respectively). Conclusion: This study found that dehydration in AIS was not associated with poor 7-day-NIHSS and 30-day-mRS outcome. Further study with better diagnostic and outcome criteria is required.