Prediction of Poor Outcome after Successful Thrombectomy in Patients with Severe Acute Ischemic Stroke: A Pilot Retrospective Study
Abstract
:1. Introduction
2. Material and Methods
2.1. Patient Selection
2.2. Data Extraction
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total | Favorable Outcome (mRS Score 0–3, n = 26) | Unfavorable Outcome (mRS Score 4–6, n = 27) | p-Value | |
---|---|---|---|---|
Age | 67.89 ± 18.1 | 61.04 ± 17.86 | 74.48 ± 16.02 | 0.006 *† |
Sex | 1.000 | |||
Female | 30 (56.6%) | 15 (57.7%) | 15 (55.6%) | |
Male | 23 (43.4%) | 11 (42.3%) | 12 (44.4%) | |
Race | 0.586 | |||
White | 27 (50.9%) | 14 (53.8%) | 13 (48.1%) | |
Black/African American | 25 (47.2%) | 11 (42.3%) | 14 (51.9%) | |
Other | 1 (1.9%) | 1 (3.8%) | 0 | |
BMI | 26.42 (9.7) | 26.51 (9.1) | 26.42 (9.4) | 0.965 |
Smoking status | 0.587 | |||
No | 27 (50.9%) | 12 (46.2%) | 15 (55.6%) | |
Yes | 26 (49.1%) | 14 (53.8%) | 12 (44.4%) | |
Alcohol use | 0.148 † | |||
No | 36 (67.9%) | 15 (57.7%) | 21 (77.8%) | |
Yes | 17 (32.1%) | 11 (42.3%) | 6 (22.2%) | |
Hypertension | 0.526 | |||
No | 12 (22.6%) | 7 (26.9%) | 5 (18.5%) | |
Yes | 41 (77.4%) | 19 (73.1%) | 22 (81.5%) | |
Hyperlipidemia | 0.779 | |||
No | 33 (62.3%) | 17 (65.4%) | 16 (59.3%) | |
Yes | 20 (37.7%) | 9 (34.6%) | 11 (40.7%) | |
Diabetes mellitus | 0.119 † | |||
No | 39 (73.6%) | 22 (84.6%) | 17 (63%) | |
Yes | 14 (26.4%) | 4 (15.4%) | 10 (37%) | |
Heart disease | 0.264 | |||
No | 32 (60.4%) | 18 (69.2%) | 18 (66.7%) | |
Yes | 21 (39.6%) | 8 (30.8%) | 13 (48.1%) | |
Atrial fibrillation | 1.000 | |||
No | 35 (66%) | 17 (65.4%) | 18 (66.7%) | |
Yes | 18 (34%) | 9 (34.6%) | 9 (33.3%) | |
History of malignancy | 0.467 | |||
No | 45 (84.9%) | 21 (80.8%) | 24 (88.9%) | |
Yes | 8 (15.1%) | 5 (19.2%) | 3 (11.1%) | |
Prior cerebrovascular accident | 1.000 | |||
No | 38 (71.7%) | 19 (73.1%) | 19 (70.4%) | |
Yes | 15 (28.3%) | 7 (26.9%) | 8 (29.6%) | |
Heart rate | 85.62 ± 19.8 | 85.35 ± 22.31 | 85.89 ± 17.48 | 0.922 |
Systolic blood pressure | 143 (29) | 142.5 (24) | 144 (32.5) | 0.810 |
Diastolic blood pressure | 83 (24) | 83.5 (20.5) | 82 (23) | 0.423 |
Respiratory rate | 19 (6) | 18 (5.75) | 19 (4.5) | 0.781 |
Anticoagulant use | 1.000 | |||
No | 31 (58.5%) | 15 (57.7%) | 16 (59.3%) | |
Yes | 22 (41.5%) | 11 (42.3%) | 11 (40.7%) | |
Admission NIHSS | 25 (4) | 24.5 (3) | 25 (5) | 0.687 |
IV tPA treatment | 0.412 | |||
No | 30 (56.6%) | 13 (50%) | 17 (63%) | |
Yes | 23 (43.4%) | 13 (50%) | 10 (37%) | |
Time from symptom onset to CT in minutes | 150 (187) | 132 (126.8) | 186 (234.5) | 0.838 |
Glucose | 120 (41) | 118 (33) | 122 (43) | 0.831 |
Sodium | 139.28 ± 3.98 | 139.35 ± 3.39 | 139.22 ± 4.54 | 0.911 |
Potassium | 4.08 ± 0.55 | 4 ± 0.52 | 4.16 ± 0.58 | 0.309 |
Calcium | 8.8 (1.1) | 9.05 (1.3) | 8.7 (1) | 0.076 † |
BUN:Creatinine ratio | 15.4 (10) | 13.5 (7.8) | 21 (11.8) | 0.020 *† |
Hemoglobin | 12.6 (2) | 12.85 (1.7) | 12.6 (2.1) | 0.563 |
Hematocrit | 38.8 (6.3) | 38.85 (4.8) | 38.8 (6.6) | 0.957 |
Mean corpuscular volume | 90.6 (10.7) | 90.8 (10.2) | 89.8 (8.2) | 0.298 |
Platelet count | 231 (86) | 211 (81.3) | 241 (98.5) | 0.026 *† |
Mean platelet volume | 10.59 ± 0.97 | 10.71 ± 1 | 10.48 ± 0.96 | 0.395 |
Neutrophil count | 6888 (6206) | 6705 (5674) | 6919 (6529) | 0.531 |
Neutrophil:Platelet ratio | 33.1 (2.8) | 36.35 (21.1) | 30.75 (19.6) | 0.115 † |
Baseline NCCT ASPECTS | 9 (3) | 9 (2.8) | 9 (2.5) | 0.812 |
Occlusion site on CT | 0.624 | |||
Distal intracranial ICA only | 8 (15.1%) | 2 (7.7%) | 6 (22.2%) | |
M1 only | 33 (61.1%) | 18 (69.2%) | 15 (55.6%) | |
M1 and M2 | 5 (9.4%) | 2 (7.7%) | 3 (11.1%) | |
ICA and M1 | 3 (5.7%) | 2 (7.7%) | 1 (3.7%) | |
M2 only | 4 (7.5%) | 2 (7.7%) | 2 (7.4%) | |
Occlusion laterality | 0.372 | |||
Left | 37 (69.8%) | 20 (76.9%) | 17 (63%) | |
Right | 16 (30.2%) | 6 (23.1%) | 10 (37%) | |
Hemorrhagic transformation on post-procedural follow up within 48 h | 0.704 | |||
No | 45 (84.9%) | 23 (88.5%) | 22 (81.5%) | |
Yes | 8 (15.1%) | 3 (11.5%) | 5 (18.5%) | |
Time from last known normal to groin puncture in minutes | 208 (141) | 246 (165.5) | 190 (131) | 0.168 † |
Time from groin puncture to recanalization in minutes | 35 (42) | 31.5 (42) | 42 (42) | 0.444 |
Number of passes in thrombectomy | 1 (2) | 1 (2) | 1 (1.5) | 0.861 |
mTICI score category | 0.351 | |||
2b | 21 (39.6%) | 12 (46.2%) | 9 (33.3%) | |
2c | 8 (15.1%) | 2 (7.7%) | 6 (22.2%) | |
3 | 24 (45.3%) | 12 (46.2%) | 12 (44.4%) |
Variable | OR (95% CI) | p-Value |
---|---|---|
Age | 1.051 (1.015–1.121) | 0.025 ‡ |
Platelet count | 1.014 (1.003–1.029) | 0.031 ‡ |
Calcium | 0.343 (0.074–1.005) | 0.115 |
BUN:Creatinine ratio | 1.077 (0.976–1.206) | 0.157 |
Neutrophil:platelet ratio | 0.940 (0.976–1.022) | 0.342 |
Alcohol use (yes) | 0.423 (0.063–2.446) | 0.344 |
Time from last known normal to groin puncture in minutes | 1.001 (0.998–1.004) | 0.572 |
Diabetes mellitus (yes) | 1.400 (0.226–9.342) | 0.716 |
Variable | B-Coefficient (95% CI) | OR (95% CI) | p-Value |
---|---|---|---|
Model 1 | |||
Intercept | −3.231 [(−6.141)–(−0.832)] | - | - |
Age | 0.048 (0.014–0.089) | 1.049 (1.014–1.092) | 0.011 |
Model 2 | |||
Intercept | −2.169 [(−4.513)–(−0.231)] | - | - |
Platelet Count | 0.009 (0.002–0.019) | 1.010 (1.002–1.020) | 0.038 |
Model 3 | |||
Intercept | −6.484 [(−11.385)–(−2.764)] | - | - |
Age | 0.055 (0.018–0.102) | 1.057 (1.018–1.107) | 0.009 |
Platelet Count | 0.012 (0.003–0.024) | 1.012 (1.003–1.024) | 0.029 |
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Ozkara, B.B.; Karabacak, M.; Kotha, A.; Aslan, A.; Hamam, O.; Edpuganti, N.; Hoseinyazdi, M.; Wang, R.; Cristiano, B.C.; Yedavalli, V.S. Prediction of Poor Outcome after Successful Thrombectomy in Patients with Severe Acute Ischemic Stroke: A Pilot Retrospective Study. Neurol. Int. 2023, 15, 225-237. https://doi.org/10.3390/neurolint15010015
Ozkara BB, Karabacak M, Kotha A, Aslan A, Hamam O, Edpuganti N, Hoseinyazdi M, Wang R, Cristiano BC, Yedavalli VS. Prediction of Poor Outcome after Successful Thrombectomy in Patients with Severe Acute Ischemic Stroke: A Pilot Retrospective Study. Neurology International. 2023; 15(1):225-237. https://doi.org/10.3390/neurolint15010015
Chicago/Turabian StyleOzkara, Burak B., Mert Karabacak, Apoorva Kotha, Alperen Aslan, Omar Hamam, Namratha Edpuganti, Meisam Hoseinyazdi, Richard Wang, Brian C. Cristiano, and Vivek S. Yedavalli. 2023. "Prediction of Poor Outcome after Successful Thrombectomy in Patients with Severe Acute Ischemic Stroke: A Pilot Retrospective Study" Neurology International 15, no. 1: 225-237. https://doi.org/10.3390/neurolint15010015