背景:侧支状态(CS)在梗死发生率中起着至关重要的作用,血栓切除术后出血的风险,和前循环大血管闭塞(LVOs)继发急性缺血性卒中(AIS)患者的总体临床结局。先前已将低灌注强度比验证为CS的间接非侵入性预处理成像生物标志物。除了成像,入院实验室检查结果的紊乱也会影响AIS-LVO患者的预后。因此,我们的研究旨在评估入院实验室结果之间的关系,基线特征,CS,通过AIS-LVO患者的低灌注强度比评估。
结果:在这项回顾性研究中,纳入了前循环LVO继发AIS的连续患者,这些患者接受了预处理CT灌注.通过RAPID(缺血视图,MenloPark,CA)产生了低灌注强度比。二元logistic回归模型用于评估患者基线特征之间的关系,入院化验结果,可怜的CS我们的研究共纳入了2017年1月至2022年9月期间221例AIS-LVO的连续患者(平均±SD年龄,67.0±15.8岁;119名男性[53.8%])。多变量logistic回归显示,由心源性和隐源性原因引起的AIS患者(校正比值比[OR],2.67;95%CI,1.20-5.97;P=0.016),那些入院时美国国立卫生研究院卒中量表评分≥12分的人(调整后的OR,3.12;95%CI,1.61-6.04;P=0.001),和男性患者(调整后的OR,2.06;95%CI,1.13-3.77;P=0.018)与不良CS相关。
结论:由心源性或隐源性原因引起的卒中,入院美国国立卫生研究院卒中量表评分≥12分,男性与CS差相关,由AIS-LVO患者的低灌注强度比定义。
BACKGROUND: Collateral status (CS) plays a crucial role in infarct growth rate, risk of postthrombectomy hemorrhage, and overall clinical outcomes in patients with acute ischemic stroke (AIS) secondary to anterior circulation large-vessel occlusions (LVOs). Hypoperfusion intensity ratio has been previously validated as an indirect noninvasive pretreatment imaging biomarker of CS. In addition to imaging, derangements in admission laboratory findings can also influence outcomes in patients with AIS-LVO. Therefore, our study aims to assess the relationship between admission laboratory findings, baseline characteristics, and CS, as assessed by hypoperfusion intensity ratio in patients with AIS-LVO.
RESULTS: In this retrospective study, consecutive patients presenting with AIS secondary to anterior circulation LVO who underwent pretreatment computed tomography perfusion were included. The computed tomography perfusion data processed by RAPID (Ischema View, Menlo Park, CA) generated the hypoperfusion intensity ratio. Binary logistic regression models were used to assess the relationship between patients\' baseline characteristics, admission laboratory findings, and poor CS. A total of 221 consecutive patients with AIS-LVO between January 2017 and September 2022 were included in our study (mean±SD age, 67.0±15.8 years; 119 men [53.8%]). Multivariable logistic regression showed that patients with AIS caused by cardioembolic and cryptogenic causes (adjusted odds ratio [OR], 2.67; 95% CI, 1.20-5.97; P=0.016), those who presented with admission National Institutes of Health Stroke Scale score ≥12 (adjusted OR, 3.12; 95% CI, 1.61-6.04; P=0.001), and male patients (adjusted OR, 2.06; 95% CI, 1.13-3.77; P=0.018) were associated with poor CS.
CONCLUSIONS: Stroke caused by cardioembolic or cryptogenic causes, admission National Institutes of Health Stroke Scale score of ≥12, and male sex were associated with poor CS, as defined by hypoperfusion intensity ratio in the patients with AIS-LVO.