Estimated Glomerular Filtration Rate and Risk of Survival in Acute Stroke

Objective: To assess the risk of survival in acute stroke using the MDRD equation derived estimated glomerular filtration rate.Design: A prospective observational cross-sectional study.Setting: Medical wards of a tertiary care hospital.Subjects: Eighty three acute stroke patients had GFR calculated within 48 hours of admission after basic data were captured.Outcome measures: Stroke outcome was defined as either discharged or still-in-care (survived) or all cause in-hospital death. GFR was estimated by the MDRD equation, stroke severity was assessed by the Canadian Neurological Scale (CNS). Data were compared between the GFR groups of < 60ml/min and . 60ml/min. Relative risks (RR) and odds ratios (OR) for stroke outcomes (survival and death) were estimated between the GFR groups and the homogeneity of the odds ratios among the different layers of stroke severity (CNS < 6.5 and . 6.5) was determined by Breslow-Day and Taronefs test. Matanel Hazensel and Cochranfs tests were used to determine conditional independence and the common odds ratio with stroke severity as a layering variable.Results: No significant differences were found between the age and sex distribution of the two GFR groups. Serum urea and creatinine and CNS were significantly different between the GFR groups (p<0.001, <0.001, <0.001). RR of survival and death for the GFR groups-less than 60ml/min and above or equal to 60ml/min were (0.425 and 1.204) and (2.360 and 0.830). The OR of survival for GFR below 60ml/min compared to GFRabove or equal to 60ml/min was 0.353. There was homogeneity across the two layers of stroke severity (CNS score less than 6.5 and above or equal to 6.5), p=0.612 and 0.612.Conclusion: Independent of stroke severity, GFR is a surrogate in the assessment of the risk of survival in acute strok