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Introduction <p>Stroke ranks as the second leading cause of death worldwide. Ischemic strokes account for approximately 62% of all strokes, followed by ICH 28% and SAH 10%.Hypoalbuminemia and Elevated BUN are linked to poor prognosis in AIS patients.BUN to ALB ratio (BAR), has been recently proposed as a simple and sensitive indicator of prognosis in AIS simultaneously reflecting inflammation, metabolic stress, and renal perfusion status, , rather than a direct nutritional marker. The Alberta stroke program early CT score (ASPECTS) is a 10-point quantitative topographic CT scan score used for middle cerebral artery (MCA) stroke patients.</p> Aims and Objectives <p>We aimed to study Blood Urea Nitrogen to Albumin Ratio in Acute Ischemic stroke and its association with Alberta stroke program early CT score (ASPECTS).</p> Materials and Methods <p>This prospective cohort study was conducted at SRN Hospital, MLN Medical College, Prayagraj, from June 2023 to May 2024. Purposive sampling was used. Only patients with ischemic stroke involving the MCA territory were included. Patient of Hemorrhagic stroke, prior demyelinating disorder, Underlying Malignancy, Renal failure and Hepatic failure were excluded.</p> Result <p>A total of 100 patients of acute ischemic stroke (MCA territory Infarct) having 75 males and 25 females were the study subjects. According to the NIHSS score, 41 patients had minor stroke (score 0-4), 30 had moderate stroke (score 5-15), 9 had moderate to severe stroke (score 16- 20) and 20 patients had severe stroke (score &gt; 20).</p> <p>The overall mean age was 70.80±8.38 years and showed increase in severity of stroke with increase in age with F-value of 178.76 and a p-value &lt; 0.001; thus, showing strong age-dependent pattern in stroke severity. The BAR showed a strong association with severity of stroke; with significant p value of&lt;0.001. The ASPECTS decreases as stroke severity increases. Patients with minor strokes had the highest mean ASPECTS of 8.61±0.77, while those with severe strokes had the lowest mean ASPECTS of 3.10±0.79, The overall mean ASPECTS is 5.29±1.48 with F-value of 130.78 and a p-value &lt;0.001 shows statistically significant association.</p> <p>The mean BAR was significantly higher in patients with ASPECTS ≤7 (11.90 ± 5.12) compared to ASPECTS &gt;7 (6.56 ± 0.21). The t-value was 2.75, and the p-value was 0.007, indicating a statistically significant difference.</p> Conclusion <p>This study is first of its kind where the severity of acute ischemic stroke as per neuroimaging ALBERTA ASPECTS score was associated with Blood Urea Nitrogen to Albumin ratio (BAR) and established that BAR is a good marker. BAR showed a strong association with Alberta ASPECT score. A higher BAR is associated with lower ASPECTS score less than 7, which corresponds to more severe early ischemic changes observed on CT scan in acute stroke patients. Mean BAR was 11.53±5.12; and as the ratio increases, the severity of stroke also increases based on NIHSS.</p>

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Serum Blood Urea Nitrogen to Albumin Ratio as Marker of Severity in Acute Ischemic Stroke and its Association with Neuroimaging (ASPECT Score)

  • 期刊论文

  • 发表日期：

    2026年2月27日

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  • Ajeet Kumar Chaurasia,
  • Poonam Gupta,
  • Ashish Kumar Gautam,
  • Archana Ojha

摘要

Introduction

Stroke ranks as the second leading cause of death worldwide. Ischemic strokes account for approximately 62% of all strokes, followed by ICH 28% and SAH 10%.Hypoalbuminemia and Elevated BUN are linked to poor prognosis in AIS patients.BUN to ALB ratio (BAR), has been recently proposed as a simple and sensitive indicator of prognosis in AIS simultaneously reflecting inflammation, metabolic stress, and renal perfusion status, , rather than a direct nutritional marker. The Alberta stroke program early CT score (ASPECTS) is a 10-point quantitative topographic CT scan score used for middle cerebral artery (MCA) stroke patients.

Aims and Objectives

We aimed to study Blood Urea Nitrogen to Albumin Ratio in Acute Ischemic stroke and its association with Alberta stroke program early CT score (ASPECTS).

Materials and Methods

This prospective cohort study was conducted at SRN Hospital, MLN Medical College, Prayagraj, from June 2023 to May 2024. Purposive sampling was used. Only patients with ischemic stroke involving the MCA territory were included. Patient of Hemorrhagic stroke, prior demyelinating disorder, Underlying Malignancy, Renal failure and Hepatic failure were excluded.

Result

A total of 100 patients of acute ischemic stroke (MCA territory Infarct) having 75 males and 25 females were the study subjects. According to the NIHSS score, 41 patients had minor stroke (score 0-4), 30 had moderate stroke (score 5-15), 9 had moderate to severe stroke (score 16- 20) and 20 patients had severe stroke (score > 20).

The overall mean age was 70.80±8.38 years and showed increase in severity of stroke with increase in age with F-value of 178.76 and a p-value < 0.001; thus, showing strong age-dependent pattern in stroke severity. The BAR showed a strong association with severity of stroke; with significant p value of<0.001. The ASPECTS decreases as stroke severity increases. Patients with minor strokes had the highest mean ASPECTS of 8.61±0.77, while those with severe strokes had the lowest mean ASPECTS of 3.10±0.79, The overall mean ASPECTS is 5.29±1.48 with F-value of 130.78 and a p-value <0.001 shows statistically significant association.

The mean BAR was significantly higher in patients with ASPECTS ≤7 (11.90 ± 5.12) compared to ASPECTS >7 (6.56 ± 0.21). The t-value was 2.75, and the p-value was 0.007, indicating a statistically significant difference.

Conclusion

This study is first of its kind where the severity of acute ischemic stroke as per neuroimaging ALBERTA ASPECTS score was associated with Blood Urea Nitrogen to Albumin ratio (BAR) and established that BAR is a good marker. BAR showed a strong association with Alberta ASPECT score. A higher BAR is associated with lower ASPECTS score less than 7, which corresponds to more severe early ischemic changes observed on CT scan in acute stroke patients. Mean BAR was 11.53±5.12; and as the ratio increases, the severity of stroke also increases based on NIHSS.