Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
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
First author：Fengli Che
Corresponding author：Xiaokun Geng
essential_information
- Person in charge：Fengli Che
- Data Sources： OTHERS
- Number of papers：OTHERS20230197
- Published time：2023-11-27
2023-11-27
Published articles
Journal：World Neurosurgery
Publication type: Original Contributions
IF(IF): 0
PMID: 38030069 Link To Pubmed Full text Download
Background And Purpose
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).
Method
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.
Conclusion
MCs in AIS patients after EVT have a high incidence, despite successful reperfusion, adversely affecting clinical outcomes and increasing short-term mortality.
Main results
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.