国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

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

第一作者：Fengli Che

通讯作者：Xiaokun Geng

acute ischemic stroke endovascular treatment medical complications outcome symptomatic intracerebral hemorrhage

基本信息

  • 负责人：Fengli Che
  • 数据来源： OTHERS
  • 论文编号：OTHERS20230197
  • 发表时间：2023-11-27

2023-11-27

已发表文章

发表杂志：World Neurosurgery

发表类型: Original Contributions

影响因子(IF): 0

PMID: 38030069 Pubmed原文链接 全文下载

主要研究背景及目的

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).

方法

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 (sICH) and mortality at seven and 30 days.

结论

MCs in AIS patients after EVT have a high incidence, despite successful reperfusion, adversely affecting clinical outcomes and increasing short-term mortality.

主要结果

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 to75 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 sICH (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 seven days.