ASSOCIATION OF SERUM URIC LEVEL AND SEVERITY OF ACUTE ISCHEMIC STROKE: A PROSPECTIVE STUDY

Abstract

Background: Stroke is a leading cause of morbidity and mortality worldwide, with early identification of severity being crucial for prognosis and management. Serum uric acid (SUA), a known antioxidant, has been implicated in the pathophysiology of acute ischemic stroke, but its relationship with stroke severity remains controversial. This study aimed to evaluate the correlation between stroke severity, assessed by the National Institutes of Health Stroke Scale (NIHSS), and serum uric acid levels at hospital presentation. Materials and Methods: This prospective longitudinal cohort study was conducted over a period of 18 months in a tertiary care center. A total of 200 adult patients presenting within 48 hours of onset of stroke symptoms were included and divided into two groups based on sex-specific serum uric acid levels: normal (Group N) and elevated (Group H). Patients underwent detailed clinical evaluation, neuroimaging (CT/MRI), and assessment of stroke severity using NIHSS. Functional outcomes were evaluated using the modified Rankin Scale (mRS) at 14 days. Statistical analysis was performed using appropriate tests, with a p-value <0.05 considered significant. Results: The demographic characteristics were comparable between the two groups, with no significant difference in age or gender distribution. Mean serum uric acid levels were significantly higher in Group H compared to Group N (6.99 ± 0.91 mg/dL vs 4.87 ± 0.93 mg/dL; p < 0.001). Patients with elevated SUA showed a higher proportion of moderate-to-severe and severe stroke compared to those with normal SUA levels (p = 0.0079). Clinical presentations with higher mRS scores, including hemiparesis, aphasia, and hemiplegia, were more frequent in the elevated SUA group. Correlation analysis demonstrated a weak but statistically significant positive correlation between serum uric acid levels and both NIHSS scores (r = 0.14, p < 0.01) and mRS scores (r = 0.19, p = 0.027), indicating an association with increased stroke severity and poorer functional outcomes. Conclusion: Elevated SUA levels at hospital presentation are associated with greater stroke severity and worse functional outcomes. Although the correlation is weak, serum uric acid may serve as a useful adjunct biomarker in the early assessment of stroke severity. Further studies are needed to establish its definitive role in prognostication and management of acute stroke.