Dataset Information

Oxygen saturation before and after mechanical thrombectomy and functional outcome in patients with acute ischemic stroke.

ABSTRACT:

Background and purpose

Currently, there is a lack of effective neuroprotective strategies to break the ceiling effect of mechanical thrombectomy (MT), and one of the most promising is normobaric oxygen treatment. However, the impact of pre- and post-MT oxygen saturation on clinical outcomes in patients with acute ischemic stroke (AIS) remains unclear. We aimed to determine the influence of preoperative and postoperative oxygen saturation on 3-month poor outcome in patients with AIS.

Methods

A total of 239 consecutive stroke patients with successful recanalization by MT between May 2017 and March 2021 were analyzed. Oxygen saturation was measured non-invasively by pulse oximetry at baseline and continually after MT. Regression analysis was used to assess the association of preoperative and postoperative oxygen saturation with a 3-month poor outcome (modified Rankin Scale score: 3-6).

Results

Decreased preoperative oxygen saturation level was associated with an increased risk of poor outcome (odds ratio, 0.85; 95% CI, 0.73-0.98; P = 0.0293). Postoperative oxygen saturation had the opposite effect on poor outcome (odds ratio, 1.60; 95% CI, 1.13-2.27; P = 0.0088).

Conclusion

Preoperative and postoperative oxygen saturation have different impacts on 3-month poor outcome in patients with AIS with successful recanalization by MT.

SUBMITTER: Yu S

PROVIDER: S-EPMC9575944 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Oxygen saturation before and after mechanical thrombectomy and functional outcome in patients with acute ischemic stroke.

Yu Shuhong S Yu Shuai S Zhang Hang H Dai Qingyong Q Huang Hao H Luo Yi Y Guo Zhiliang Z Xiao Guodong G

Frontiers in cardiovascular medicine 20220930

<h4>Background and purpose</h4>Currently, there is a lack of effective neuroprotective strategies to break the ceiling effect of mechanical thrombectomy (MT), and one of the most promising is normobaric oxygen treatment. However, the impact of pre- and post-MT oxygen saturation on clinical outcomes in patients with acute ischemic stroke (AIS) remains unclear. We aimed to determine the influence of preoperative and postoperative oxygen saturation on 3-month poor outcome in patients with AIS.<h4>M ...[more]

PMID: 36262210

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Project description:BackgroundEosinophils contribute to antibacterial defense by releasing mitochondrial DNA, which are decreased in patients with acute ischemic stroke (AIS). However, the impact of eosinophils on stroke-associated pneumonia (SAP) among patients with AIS remains unclear. Moreover, whether SAP is in the path of the association between eosinophils and clinical outcomes also remains unclear. We aimed to assess the relationships between eosinophils, SAP, and clinical outcome after mechanical thrombectomy in patients with AIS.MethodsA total of 328 consecutive patients with AIS who underwent mechanical thrombectomy between May 2017 and March 2021 were analyzed. Their baseline data and peripheral eosinophil counts were recorded on admission. Regression analysis was used to assess the effect of eosinophils on SAP, and its effect on poor outcome is defined as a modified Rankin Scale score of 3-6 at month 3 after admission. Mediation analysis was utilized to assess the proportion of the total effect of SAP on the association between eosinophils and poor outcomes.ResultsMultivariate analysis revealed that eosinophils was independently associated with SAP after adjusting for potential confounders (odds ratio, 0.00; 95% CI, 0.00-0.38; P = 0.0267), which are consistent with the result of eosinophils (dichotomous) as a categorical variable (odds ratio, 0.54; 95% CI, 0.31-0.96; P = 0.0342). A non-linear relationship was detected between eosinophils and SAP, whose inflection point was 0.06. Subgroup analyses further confirmed these associations. Eosinophils were also associated with poor outcomes (odds ratio, 0.00; 95% CI, 0.00-0.14; P = 0.0124). Additionally, mediation analysis found that SAP partially mediated the negative relationship between eosinophils and poor outcome (indirect effect = -0.169; 95% CI:-0.339 --0.040, P < 0.001).ConclusionOur findings suggested that a lower eosinophil level was associated with higher SAP and poorer outcome, and SAP might play an important effect in the association between eosinophils and poor outcomes.

Project description:Background and purposeThere is no consensus on the optimal antithrombotic medication for patients with acute ischemic stroke with anterior circulation tandem occlusions treated with emergent carotid stent placement and mechanical thrombectomy. The identification of factors influencing hemorrhagic risks can assist in creating appropriate therapeutic algorithms for such patients. This study aimed to investigate the impact of medical therapy on functional and safety outcomes in patients treated with carotid stent placement and mechanical thrombectomy for tandem occlusions.Materials and methodsA multicenter retrospective study on prospectively collected data was conducted. Only patients treated with carotid stent placement and mechanical thrombectomy for tandem occlusions of the anterior circulation were included. Univariate and multivariate analyses were performed on preprocedural, procedural, and postprocedural variables to assess factors influencing clinical outcome, symptomatic intracranial hemorrhage, stent patency, and successful intracranial vessel recanalization.ResultsNinety-five patients with acute ischemic stroke and tandem occlusions were included. Good clinical outcome (mRS ≤ 2) at 3 months was reached by 33 (39.3%) patients and was associated with baseline ASPECTS ≥ 8 (OR = 1.53; 95% CI, 1.16-2.00), ≤2 mechanical thrombectomy attempts (OR = 0.71; 95% CI, 0.55-0.99), and the absence of symptomatic intracranial hemorrhage (OR = 0.13; 95% CI , 0.03-0.51). Symptomatic intracranial hemorrhage was associated with a higher amount of intraprocedural heparin, ASPECTS ≤ 7, and ≥3 mechanical thrombectomy attempts. No relationships among types of acute antiplatelet regimen, intravenous thrombolysis, and symptomatic intracranial hemorrhage were observed. Patients receiving dual-antiplatelet therapy after hemorrhagic transformation had been ruled out on 24-hour CT were more likely to achieve functional independence and had a lower risk of symptomatic intracranial hemorrhage.ConclusionsDuring carotid stent placement and mechanical thrombectomy for tandem occlusion treatment, higher intraprocedural heparin dosage (≥3000 IU) increased symptomatic intracranial hemorrhage risk when the initial ASPECTS was ≤7, and mechanical thrombectomy needs more than one passage for complete recanalization. Antiplatelets antiplatelets use were safe, and dual-antiaggregation therapy was related to better functional outcomes.

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Dataset Information

Oxygen saturation before and after mechanical thrombectomy and functional outcome in patients with acute ischemic stroke.

Background and purpose

Methods

Results

Conclusion

Publications

Oxygen saturation before and after mechanical thrombectomy and functional outcome in patients with acute ischemic stroke.

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