Association between serum uric acid to serum creatinine ratio and poor functional outcomes in patients with acute ischemic stroke

Abstract Background and purpose The role of serum uric acid (SUA) in prognosis is controversial because SUA levels largely depend on renal clearance function. This study aimed to investigate the association between renal function‐normalized SUA (SUA to serum creatinine [SCr] ratio [SUA/SCr ratio]) and poor functional outcomes in patients with acute ischemic stroke (AIS). Methods All patients were recruited from the Third China National Stroke Registry. Poor functional outcomes were defined by modified Rankin Scale (mRS) scores of 3–6 or 2‐6 at 3 months and 1 year. Results Among 8169 enrolled patients, the median (interquartile range) SUA/SCr ratio was 4.19 (3.47–5.08). Compared with patients in the fourth quintile group, those in the first quintile group had higher proportions of mRS scores 3–6 (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.24–1.93) and mRS scores 2–6 (OR 1.28, 95% CI 1.08–1.53) at 3 months. The addition of SUA/SCr ratio to the conventional risk model had a greater incremental value than the addition of either SUA or SCr alone. Subgroup analysis showed that the association was only significant in patients with normal kidney function ( p for interaction<0.05). Similar results were found for outcomes at 1 year. Conclusions A lower SUA/SCr ratio was associated with poor functional outcomes in patients with AIS at 3 months and at 1 year, suggesting the potential use of SUA/SCr ratio in clinical practice as a preferable marker for stroke outcomes.