PT - JOURNAL ARTICLE AU - Bahouth, Mona N. AU - Gaddis, Andrew AU - Hillis, Argye E. AU - Gottesman, Rebecca F. TI - Pilot study of volume contracted state and hospital outcome after stroke AID - 10.1212/CPJ.0000000000000419 DP - 2018 Feb 01 TA - Neurology: Clinical Practice PG - 21--26 VI - 8 IP - 1 4099 - http://cp.neurology.org/content/8/1/21.short 4100 - http://cp.neurology.org/content/8/1/21.full AB - Background An increasing body of research suggests that acute stroke patients who are dehydrated may have worsened functional outcomes. We sought to explore the relationship between a volume contracted state (VCS) at the time of ischemic stroke and hospital outcomes as compared with euvolemic patients.Methods We enrolled a consecutive series of ischemic stroke patients from a single academic stroke center within 12 hours from stroke onset. VCS was defined via surrogate markers (blood urea nitrogen/creatinine ratio >15 and urine specific gravity >1.010). The primary outcome was change in NIH Stroke Scale (NIHSS) score from admission to discharge. Multivariable analyses included adjustment for demographics and infarct size.Results Over an 11-month study period, 168 patients were eligible for inclusion. Of the126 with complete laboratory and MRI data, 44% were in a VCS at the time of admission. Demographics were similar in both the VCS and euvolemic groups, as were baseline NIHSS scores (6.7 vs 7.3; p = 0.63) and infarct volumes (12 vs 16 mL; p = 0.48). However, 42% of patients in a VCS demonstrated early clinical worsening, compared with 17% of the euvolemic group (p = 0.02). A VCS remained a significant predictor of worsening NIHSS in adjusted models (odds ratio 4.34; 95% confidence interval 1.75–10.76).Conclusions Acute stroke patients in a VCS demonstrate worse short-term outcomes compared to euvolemic patients, independent of infarct size. Results suggest an opportunity to explore current hydration practices.