Key result
An elevated admission blood urea nitrogen (>6.80 mmol/L) was associated with significantly lower odds of achieving a favorable functional outcome at 90 days (aOR 0.54).
Why the study?
The association between admission blood urea nitrogen and clinical outcomes in patients with large ischemic stroke undergoing endovascular treatment was unclear.
Does elevated admission blood urea nitrogen predict lower likelihood of favorable functional outcomes in patients with large ischemic stroke undergoing endovascular treatment?
Cohort (n=472)
Yes
Does elevated admission blood urea nitrogen predict lower likelihood of favorable functional outcomes in patients with large ischemic stroke undergoing endovascular treatment?
Odds Ratio: 0.54 (95% CI 0.31–0.95)
Absolute Event Rate: 26.8% vs 46.6%
p-value: p=0.032
An elevated admission BUN (>6.80 mmol/L) serves as an independent prognostic marker for a lower likelihood of functional recovery at 90 days in patients with large ischemic stroke treated with endovascular thrombectomy.
Elevated admission BUN may aid prognostication after EVT for large ischemic stroke; hypothesis-generating and requires prospective validation.
Background This study aimed to investigate the association between admission blood urea nitrogen (BUN) and clinical outcomes in patients with large ischemic stroke undergoing endovascular treatment (EVT). Methods This study was a subgroup analysis of a prospective, multicenter cohort study. 472 patients with large ischemic stroke undergoing EVT from the original database were included. Patients were stratified into three groups based on admission BUN levels. The primary effectiveness outcome was modified Rankin Scale (mRS) score 0–3 at 90 days. Safety outcomes included 90-day mortality and symptomatic intracranial hemorrhage (sICH) within 48 h. Results A total of 472 patients were included and stratified into three groups: Tertile 1 group (≤5.00 mmol/L), Tertile 2 group (5.01–6.80 mmol/L), and Tertile 3 group (>6.80 mmol/L). Compared with patients in BUN Tertile 1 group, patients in BUN Tertile 3 had significantly lower odds of achieving a favorable outcome (adjusted odds ratio [aOR] 0.54, 95% CI 0.31–0.95, p = 0.032 in Adjusted Model 1), while BUN Tertile 2 group showed no statistical significance. There were no significant differences in mortality and sICH among three groups. Subgroup analysis presented a significant interaction between BUN and age for the primary effectiveness outcome ( P for interaction = 0.036). Conclusion In patients with large ischemic stroke undergoing EVT, an elevated admission BUN (>6.80 mmol/L) was associated with a lower likelihood of favorable functional outcome at 90 days.
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Zhou et al. (2026) conducted a cohort in Large ischemic stroke undergoing endovascular treatment (n=472). Elevated admission blood urea nitrogen (>6.80 mmol/L) vs. Lower admission blood urea nitrogen (≤5.00 mmol/L) was evaluated on Favorable functional outcome (modified Rankin Scale score 0-3 at 90 days) (aOR 0.54, 95% CI 0.31-0.95, p=0.032). An elevated admission blood urea nitrogen (>6.80 mmol/L) was associated with significantly lower odds of achieving a favorable functional outcome at 90 days (aOR 0.54).
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