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Acute stroke patients had their plasma osmolality
measured at admission and at days 1, 3 and 7. Maximum plasma osmolality and
the area under curve (AUC) were also calculated during the first week.
Patients were stratified according to how they were hydrated: oral,
intravenous or both. Outcome included survival at three months after
stroke. Logistic regression was performed to examine the association
between raised plasma osmolality (above 296 mOsm/kg) and survival,
adjusting for stroke severity. Linear regression was performed to examine
the pattern of plasma osmolality across hydration groups.
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167 patients were included. Mean admission (300
mOsm/kg, SD11.4), maximum 308.1mOsm/kg, SD 17.1) and AUC (298.3 mOsm/kg, SD
11.7 ) plasma osmolality were significantly higher in those who died,
compared to survivors (293.1mOsm/kg, SD 8.2, 297.7 mOsm/kg, SD 8.7 and
291.7mOsm/kg, SD 8.1), respectively (P<0.0001). Admission plasma osmolality
above 296 mOsm/kg was significantly associated with mortality (OR: 2.95,
95% CI: 1.2 to 7.25). In patients hydrated intravenously, there was no
significant fall in plasma osmolality when compared to patients hydrated
orally (P=0.68).
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