Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke
Background Fluid therapy is commonly used for patients with severe stroke, for whom fluid balance is a safety endpoint for evaluating the therapy. We aimed to investigate the association of fluid balance with 3-month outcomes in patients with severe ischaemic stroke.Methods We enrolled patients with...
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BMJ Publishing Group
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| Series: | Stroke and Vascular Neurology |
| Online Access: | https://svn.bmj.com/content/early/2025/07/30/svn-2024-004001.full |
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| author | Ming Liu Simiao Wu Xing Hua Yanan Wang Meng Liu Linrui Huang |
| author_facet | Ming Liu Simiao Wu Xing Hua Yanan Wang Meng Liu Linrui Huang |
| author_sort | Ming Liu |
| collection | DOAJ |
| description | Background Fluid therapy is commonly used for patients with severe stroke, for whom fluid balance is a safety endpoint for evaluating the therapy. We aimed to investigate the association of fluid balance with 3-month outcomes in patients with severe ischaemic stroke.Methods We enrolled patients with severe ischaemic stroke (National Institutes of Health Stroke Scale score ≥15) admitted to the department of neurology within 24 hours after the onset of stroke symptoms. Daily fluid balance volume in millilitres was defined as 24-hour fluid input minus fluid output. We calculated the mean value of daily fluid balance for the first 3 days after admission, and categorised patients as having positive fluid balance (daily fluid balance>+500 mL), even fluid balance (between −500 and +500 mL) and negative fluid balance (<−500 mL). The primary outcome was all-cause death at 3 months. We conducted multivariable logistic regression to investigate the association of fluid balance with 3-month death, with even fluid balance as the reference group.Results Of the 354 patients (mean age 73.1±12.9 years, 48.6% males) with severe ischaemic stroke, 94 patients (26.6%) had positive fluid balance, 194 patients (54.8%) had even fluid balance and 66 patients (18.6%) had negative fluid balance. Patients with positive fluid balance had a higher risk of 3-month death (adjusted OR 2.18, 95% CI 1.24 to 3.85, p=0.007), while patients with negative fluid balance did not show a significant difference (adjusted OR 1.68, 95% CI 0.88 to 3.20, p=0.115). The restricted cubic spline analysis illustrated a U-shaped trend of dose response relationship for mean daily fluid balance in relation to the adjusted OR of 3-month death (p for non-linearity=0.02).Conclusion In patients with severe ischaemic stroke, the positive fluid balance in the first 3 days was associated with a higher risk of death at 3 months. |
| format | Article |
| id | doaj-art-5d0d06682dfa4a2cad6e4933c46c112c |
| institution | Matheson Library |
| issn | 2059-8696 |
| language | English |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Stroke and Vascular Neurology |
| spelling | doaj-art-5d0d06682dfa4a2cad6e4933c46c112c2025-07-31T05:30:13ZengBMJ Publishing GroupStroke and Vascular Neurology2059-869610.1136/svn-2024-004001Association of fluid balance with 3-month outcomes in severe acute ischaemic strokeMing Liu0Simiao Wu1Xing Hua2Yanan Wang3Meng Liu4Linrui Huang5Centre of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaInstitute of Brain Science and Diseases, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaBackground Fluid therapy is commonly used for patients with severe stroke, for whom fluid balance is a safety endpoint for evaluating the therapy. We aimed to investigate the association of fluid balance with 3-month outcomes in patients with severe ischaemic stroke.Methods We enrolled patients with severe ischaemic stroke (National Institutes of Health Stroke Scale score ≥15) admitted to the department of neurology within 24 hours after the onset of stroke symptoms. Daily fluid balance volume in millilitres was defined as 24-hour fluid input minus fluid output. We calculated the mean value of daily fluid balance for the first 3 days after admission, and categorised patients as having positive fluid balance (daily fluid balance>+500 mL), even fluid balance (between −500 and +500 mL) and negative fluid balance (<−500 mL). The primary outcome was all-cause death at 3 months. We conducted multivariable logistic regression to investigate the association of fluid balance with 3-month death, with even fluid balance as the reference group.Results Of the 354 patients (mean age 73.1±12.9 years, 48.6% males) with severe ischaemic stroke, 94 patients (26.6%) had positive fluid balance, 194 patients (54.8%) had even fluid balance and 66 patients (18.6%) had negative fluid balance. Patients with positive fluid balance had a higher risk of 3-month death (adjusted OR 2.18, 95% CI 1.24 to 3.85, p=0.007), while patients with negative fluid balance did not show a significant difference (adjusted OR 1.68, 95% CI 0.88 to 3.20, p=0.115). The restricted cubic spline analysis illustrated a U-shaped trend of dose response relationship for mean daily fluid balance in relation to the adjusted OR of 3-month death (p for non-linearity=0.02).Conclusion In patients with severe ischaemic stroke, the positive fluid balance in the first 3 days was associated with a higher risk of death at 3 months.https://svn.bmj.com/content/early/2025/07/30/svn-2024-004001.full |
| spellingShingle | Ming Liu Simiao Wu Xing Hua Yanan Wang Meng Liu Linrui Huang Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke Stroke and Vascular Neurology |
| title | Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke |
| title_full | Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke |
| title_fullStr | Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke |
| title_full_unstemmed | Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke |
| title_short | Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke |
| title_sort | association of fluid balance with 3 month outcomes in severe acute ischaemic stroke |
| url | https://svn.bmj.com/content/early/2025/07/30/svn-2024-004001.full |
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