Authors (including presenting author) :
Chan YS(1),Mok M(1),Yip KY(1),Lee TY(1),Wong TW(1),Leung CY(1),Cho HY(1),Lo E(1),Cheung CM(1)
Affiliation :
(1)Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Water is the most important primary nutrient for a healthy, well-functioning body. Insufficient fluid leads to dehydration which can induce kidney infections, failure and even stroke-in-evolution after acute ischaemic stroke. Adequate hydration for hospitalized patients is generally recommended at least 1500ml fluid a day if no contraindications. However, we often ignore dehydration induced hyperuricemia causing occasional acute gouty attacks in hospitalized acute stroke patients. Rather than multiple other factors that consuming adequate fluid is one of simplest remedies beneficial for gouty prevention.
Objectives :
To explore the influences between inadequate fluid intake and gouty attack of acute stroke patients in ASU hospitalization.
Methodology :
A prospective study was conducted to review the fluid intakes of acute stroke patients with oral feeding in ASU from Feb 2017 to Apr 2017. We summarized their average daily fluid intakes from their fluid balance charts during hospitalization and defined adequate fluid intake as reached 1500ml per day.
Result & Outcome :
A total of 108 stroke patients were under ASU and excluded 16 cases on nasogastric feeding which had adequate fluid intake without gouty attack. We enrolled 92 cases with oral feeding in the study. 4 out of 92 patients (4.3%) had adequate fluid intakes without gouty attack. 88 out of 92 (95.7%) had inadequate fluid intake; 83 out of 88 (94.3%) had no gouty attack, 5 out of 88 (5.7%) had gouty attack. The result of gouty attack related with fluid intakes yielded 100% sensitivity, 4.6% specificity, 5.7% positive predictive value and 100% negative predictive value. Moreover, the average length of hospitalization of minor to moderate stroke patients with gout attack was increased from 7 to 10 days; and major stroke patients with gouty attack was increased from 11 to 18 days. Our study had shown significant result of no gouty attack for stroke patients with adequate fluid intakes either by oral or nasogastric feeding. Although there was no statistically significant association between inadequate fluid intake and gouty attack, it was still a possible trigger for gouty attack to increase hospital stay and affect the rehabilitation progress. Boosting constant fluid intake could help fewer gouty attacks.
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