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J Korean Neurosurg Soc. 2017 Nov;60(6):620-626. doi: 10.3340/jkns.2016.1010.009. Epub 2017 Oct 25.

Elevated Blood Urea Nitrogen/Creatinine Ratio Is Associated with Venous Thromboembolism in Patients with Acute Ischemic Stroke.

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Department of Neurosurgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
Department of Neurosurgery and Neurology, The University of Texas Medical School, Houston, TX, USA.
Department of Pharmacy, Memorial Hermann - Texas Medical Center, Houston, TX, USA.
Department of Neurosurgery, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong, Korea.



Although venous thromboembolism (VTE) is frequently related to dehydration, the impact of dehydration on VTE in acute ischemic stroke (AIS) is not clear. This study investigated whether dehydration, as measured by blood urea nitrogen (BUN)/creatinine (Cr) ratio, influences the occurrence of VTE in patients with AIS.


This is a retrospective study of patients with AIS between January 2012 and December 2013. Patients with newly diagnosed AIS who experienced prolonged hospitalization for at least 4 weeks were included in this study.


Of 182 patients included in this study, 17 (9.3%) suffered VTE during the follow-up period; in two cases, VTE was accompanied by deep vein thrombosis and pulmonary embolism. Patients with VTE were more frequently female and had higher National Institutes of Health Stroke Scale (NIHSS) score, more lower limb weakness, and elevated blood urea nitrogen BUN/Cr ratio on admission. In a multivariate analysis, BUN/Cr ratio >15 (odds ratio [OR] 8.75) and severe lower limb weakness (OR 4.38) were independent risk factors for VTE.


Dehydration on admission in cases of AIS might be a significant independent risk factor for VTE.


Blood urea nitrogen; Cerebral infarction; Creatinine; Dehydration; Venous thrombosis

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