Back to Search Start Over

Prevalence and Impact of Medical Complications on Clinical Outcomes in Acute Ischemic Stroke Patients After Endovascular Therapy – Data From a Comprehensive Stroke Unit in China.

Authors :
Che, Fengli
Wang, Anxin
Ju, Yi
Liu, Liping
Ma, Ning
Cheng, Zhe
Duan, Honglian
Zhao, Xingquan
Geng, Xiaokun
Source :
World Neurosurgery. Feb2024, Vol. 182, pe386-e399. 14p.
Publication Year :
2024

Abstract

We aim to assess the incidence and impact of in-hospital medical complications (MCs) on clinical outcomes in acute ischemic stroke (AIS) patients after endovascular therapy (EVT). AIS patients who underwent EVT were consecutively recruited from January 2019 to July 2022. The primary outcome was a poor 3-month functional outcome, defined as a modified Rankin Scale score (mRS) of 3–6. The safety variables were symptomatic intracerebral hemorrhage and mortality at 7 and 30 days. A total of 306 (50.1%) patients experienced at least one of the MCs. The most common MC was pneumonia (42.6%). Multivariate analysis revealed that the setting of MCs was an independent predictor of a poor 3-month functional outcome (adjusted odds ratio [aOR] 4.40, 95% confidence interval [CI] 3.01–6.42; P < 0.001). In the subgroup analysis, this trend was significant, especially in the patients aged 60–75 years (aOR 5.87, 95% CI 3.45–9.97; P < 0.001) or with baseline NIHSS (≤16) (aOR 5.05, 95% CI 2.84–9.01; P < 0.001). For individuals, cardiac events (aOR 8.56, 95% CI 4.05–18.09; P < 0.001), pneumonia (aOR 5.08, 95% CI 3.42–7.55; P < 0.001), and gastrointestinal bleeding (GIB) (aOR 6.12, 95% CI 3.40–11.01; P < 0.001) were independently associated with the poor 3-month outcome. The setting of MCs was independently associated with symptomatic intracerebral hemorrhage (aOR 2.11, 95% CI 1.22–3.64; P = 0.007) and mortality at 30 days (aOR 2.11, 95% CI 1.22–3.64; P = 0.007) after adjustment, but not with mortality at 7 days. MCs in AIS patients after EVT have a high incidence, despite successful reperfusion, adversely affecting clinical outcomes and increasing short-term mortality. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
18788750
Volume :
182
Database :
Academic Search Index
Journal :
World Neurosurgery
Publication Type :
Academic Journal
Accession number :
175499036
Full Text :
https://doi.org/10.1016/j.wneu.2023.11.113