Abstract：
OBJECTIVE: The impact of low platelet count on outcomes in patients with Acute Ischemic Stroke (AIS) undergoing Mechanical Thrombectomy (MT) is still unclear. In this study we have further explored the effect of thrombocytopenia on the safety and efficacy of MT in patients with anterior circulation Large Vessel Occlusion (LVO) stroke.
METHODS: Patients with AIS who underwent MT at our center between June 2015 and November 2021 were examined. Based on the platelet count recorded on admission patients were divided into two groups: those with thrombocytopenia (<150 × 109/L) and those without thrombocytopenia (≥ 150 × 109/L). Symptomatic Intracranial Hemorrhage (sICH) was the primary safety outcome. The efficacy outcome was functional independence defined as a 90-day modified Rankin Scale (mRS) score of 0-2. Multivariate logistic regression models were used to determine the risk factors for post-procedure sICH and 90-day functional outcomes.
RESULTS: Among 302 patients included in the study, thrombocytopenia was detected in 111 (36.8%) cases. Univariate analysis showed age, the proportion of atrial fibrillation, the rates of sICH, 90-day poor outcomes, and mortality to be higher in patients with thrombocytopenia (all p < 0.05). Multivariable analysis showed thrombocytopenia to be independently associated with a higher rate of sICH (OR 2.022, 95% CI 1.074-3.807, p =0.029) however, thrombocytopenia did not affect the 90-day functional outcomes (OR 1.045, 95%CI 0.490-2.230, p =0.909) and mortality (OR 1.389, 95% CI 0.467- 4.130 p = 0.554).
CONCLUSIONS: Thrombocytopenia may increase the risk of sICH but not affect the 90-day functional outcomes and mortality in patients with AIS treated with MT..
METHODS: Patients with AIS who underwent MT at our center between June 2015 and November 2021 were examined. Based on the platelet count recorded on admission patients were divided into two groups: those with thrombocytopenia (<150 × 109/L) and those without thrombocytopenia (≥ 150 × 109/L). Symptomatic Intracranial Hemorrhage (sICH) was the primary safety outcome. The efficacy outcome was functional independence defined as a 90-day modified Rankin Scale (mRS) score of 0-2. Multivariate logistic regression models were used to determine the risk factors for post-procedure sICH and 90-day functional outcomes.
RESULTS: Among 302 patients included in the study, thrombocytopenia was detected in 111 (36.8%) cases. Univariate analysis showed age, the proportion of atrial fibrillation, the rates of sICH, 90-day poor outcomes, and mortality to be higher in patients with thrombocytopenia (all p < 0.05). Multivariable analysis showed thrombocytopenia to be independently associated with a higher rate of sICH (OR 2.022, 95% CI 1.074-3.807, p =0.029) however, thrombocytopenia did not affect the 90-day functional outcomes (OR 1.045, 95%CI 0.490-2.230, p =0.909) and mortality (OR 1.389, 95% CI 0.467- 4.130 p = 0.554).
CONCLUSIONS: Thrombocytopenia may increase the risk of sICH but not affect the 90-day functional outcomes and mortality in patients with AIS treated with MT..
摘要：
目的：低血小板计数对急性缺血性卒中（AIS）患者机械血栓切除术（MT）预后的影响尚不清楚。在这项研究中，我们进一步探讨了血小板减少症对前循环大血管闭塞（LVO）卒中患者MT的安全性和有效性的影响。
方法：对2015年6月至2021年11月在我们中心接受MT治疗的AIS患者进行检查。根据入院时记录的血小板计数，将患者分为两组：血小板减少症（<150×109/L）和无血小板减少症（≥150×109/L）。症状性颅内出血（sICH）是主要的安全结局。疗效结果是功能独立性，定义为90天的改良Rankin量表（mRS）评分为0-2。使用多变量逻辑回归模型来确定术后sICH和90天功能结局的危险因素。
结果：在纳入研究的302名患者中，在111例（36.8％）中发现了血小板减少症。单因素分析显示年龄,心房颤动的比例，sICH的比率，90天的不良结果，血小板减少症患者的死亡率较高（均p＆＃60;0.05）。多变量分析显示，血小板减少与sICH发生率较高独立相关（OR2.022，95％CI1.074-3.807，p=0.029），血小板减少不影响90天功能结局(OR1.045,95CI0.490-2.230,p=0.909)和死亡率(OR1.389,95%CI0.467-4.130p=0.554).
结论：在接受MT治疗的AIS患者中，血小板减少可能会增加sICH的风险，但不会影响90天功能结局和死亡率。。
方法：对2015年6月至2021年11月在我们中心接受MT治疗的AIS患者进行检查。根据入院时记录的血小板计数，将患者分为两组：血小板减少症（<150×109/L）和无血小板减少症（≥150×109/L）。症状性颅内出血（sICH）是主要的安全结局。疗效结果是功能独立性，定义为90天的改良Rankin量表（mRS）评分为0-2。使用多变量逻辑回归模型来确定术后sICH和90天功能结局的危险因素。
结果：在纳入研究的302名患者中，在111例（36.8％）中发现了血小板减少症。单因素分析显示年龄,心房颤动的比例，sICH的比率，90天的不良结果，血小板减少症患者的死亡率较高（均p＆＃60;0.05）。多变量分析显示，血小板减少与sICH发生率较高独立相关（OR2.022，95％CI1.074-3.807，p=0.029），血小板减少不影响90天功能结局(OR1.045,95CI0.490-2.230,p=0.909)和死亡率(OR1.389,95%CI0.467-4.130p=0.554).
结论：在接受MT治疗的AIS患者中，血小板减少可能会增加sICH的风险，但不会影响90天功能结局和死亡率。。
