■肾损害(RI)与急性前循环大血管闭塞缺血性卒中后的不良结局相关。我们评估了急性基底动脉闭塞(ABAO)患者RI与临床结局的关系,以及RI对血管内治疗(EVT)与标准药物治疗(SMT)效果的影响。
■我们使用了来自BASILAR注册表的数据,一个观察,prospective,中国常规临床实践中ABAO患者的全国性研究。入院时记录基线估计的肾小球滤过率(eGFR)。主要结果是90天的改良Rankin量表(mRS)评分。次要结果包括有利结果(mRS评分0-3),死亡率,和症状性颅内出血(sICH)。多因素logistic回归用于评估RI与90天死亡率和功能改善的相关性。
■在829名患者中,对747名患者进行了分析。基线eGFR中位数为89mL/min/1.73m2(IQR,71-100),和350(46.8%),297(39.8%),100例(13.4%)患者的基线eGFR值分别为≥90,60-89和<60mL/min/1.73m2.RI与死亡率增加相关(调整后优势比[aOR],1.97;95%CI,1.15-3.67)在90天和1年内生存概率降低(aOR1.74;95%CI,1.30-2.33)。EVT与更好的功能改善相关(常见的aOR,2.50;95%CI,1.43-4.35),eGFR≥90mL/min/1.73mL的ABAO患者的良好结局(aOR5.42;95%CI,1.92-15.29)和较低的死亡率(aOR0.47;95%CI,0.25-0.88)。然而,RI未改变EVT与功能改善的关系(常见的aOR,3.03;95%CI,0.81-11.11),有利结果(AOR2.10;95%CI,0.45-9.79),按eGFR类别划分的死亡率(aOR0.56;95%CI,0.15-2.06)。
■在ABAO患者中,RI与EVT疗效降低、功能结局恶化、3个月时死亡率较高和1年时生存概率较低相关。
UNASSIGNED: Renal impairment (RI) is associated with unfavourable outcome after acute ischaemic stroke with anterior circulation large vessel occlusion. We assessed the association of RI with clinical outcomes in patients with acute basilar artery occlusion (ABAO), and the impact of RI on the effects of endovascular therapy (EVT) versus standard medical treatment (SMT).
UNASSIGNED: We used data from the BASILAR registry, an observational, prospective, nationwide study of patients with ABAO in routine clinical practice in China. Baseline estimated glomerular filtration rate (eGFR) was recorded at admission. The primary outcome was the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included favourable outcome (mRS score 0-3), mortality, and symptomatic intracranial haemorrhage (sICH). Multivariate logistic regression was used to assess the association of RI with mortality and functional improvement at 90 days.
UNASSIGNED: Among 829 patients enrolled, 747 patients were analysed. The median baseline eGFR was 89 mL/min/1.73m2 (IQR, 71-100), and 350 (46.8%), 297 (39.8%), and 100 (13.4%) patients had baseline eGFR values of ≥90, 60-89, and <60 mL/min/1.73m2, respectively. RI was associated with increased mortality (adjusted odds ratio [aOR], 1.97; 95% CI, 1.15-3.67) at 90 days and decreased survival probability (aOR 1.74; 95% CI, 1.30-2.33) within 1 year. EVT was associated with better functional improvement (common aOR, 2.50; 95% CI, 1.43-4.35), favourable outcome (aOR 5.42; 95% CI, 1.92-15.29) and lower mortality (aOR 0.47; 95% CI, 0.25-0.88) in ABAO patients with eGFR ≥90 mL/min/1.73m2. However, RI was not modified the relationship of EVT with functional improvement (common aOR, 3.03; 95% CI, 0.81-11.11), favourable outcome (aOR 2.10; 95% CI, 0.45-9.79), and mortality (aOR 0.56; 95% CI, 0.15-2.06) by eGFR categories.
UNASSIGNED: RI is associated with reduced efficacy of EVT and worse functional outcome and higher mortality at 3 months and lower survival probability at 1 year in patients with ABAO.