ABSTRACT NUMBER: ESOC2026YS271 PROGNOSTIC VALUE OF ADMISSION UREA TO CREATININE RATIO IN STROKE PATIENTS UNDERGOING ENDOVASCULAR THROMECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Background and aims This study aims to summarize and evaluate the evidence assessing the association of parameters of poor outcomes in ischemic stroke patients undergoing endovascular thrombectomy (EVT) with the urea to creatinine (BUN/Cr) ratio at admission Methods PubMed, Web of science, and Embase, were searched from the inception to July 2025. Studies assessing the association between elevated admission BUN/Cr ratio and poor outcomes in ischemic stroke patients undergoing EVT were included. Poor outcomes comprised failed recanalization (thrombolysis in cerebral infarction score ≥ 2a), symptomatic hemorrhagic transformation (≥4-point National Institutes of Health Stroke Scale increase), unfavorable functional outcome (modified Rankin score 3-5), and all-cause mortality. Non-English papers, case reports, reviews, letters, commentaries, and conference abstracts were excluded. Risk of bias of finally included studies was assessed by the QUIPS tool. Data of adjusted Odds ratio (aOR) for multivariable analysis with 95% confidence interval (CI) were pooled in the meta-analysis. Results After screening for eligible studies, 2 articles with total sample size of 436 patients were included. Predefined BUN/Cr cut offs were 15 and 22. Elevated BUN/CR ratio above mentioned levels were statistically associated with more level of insufficient recanalization (aOR: 1.29, CI: 1.03-1.60), more rates of symptomatic hemorrhagic transformation (aOR: 1.48, CI: 1.19-1.84), more rates of unfavorable outcomes (aOR: 1.61, CI: 1.34-1.93), and more rates of mortality (aOR: 1.61, CI: 1.34-1.93). Our findings encourage fluid therapy to reduce dehydration as the most common causes of rise of BUN/Cr before EVT. Conflict of interest sana aftabi: Nothing to disclose