Predictors of death after endovascular mechanical thrombectomy in patients with acute vertebrobasilar occlusive stroke
10.3760/cma.j.issn.1673-4165.2019.09.004
- VernacularTitle: 急性椎基底动脉闭塞性卒中患者血管内机械血栓切除术后死亡的预测因素
- Author:
Wenhua LIU
1
;
Zhenhui DUAN
;
Zhangbao GUO
;
Kun TANG
;
Xiaolin WAN
;
Houjie NI
;
Minghui ZHU
Author Information
1. Department of Neurology, Wuhan No.1 Hospital, Wuhan 430022, China
- Publication Type:Journal Article
- Keywords:
Stroke;
Brain ischemia;
Vertebrobasilar insufficiency;
Thrombectomy;
Endovascular procedures;
Treatment outcome;
Risk factors
- From:
International Journal of Cerebrovascular Diseases
2019;27(9):656-661
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictors of death after endovascular mechanical thrombectomy (EMT) in patients with acute vertebrobasilar occlusive stroke (VBOS).
Methods:Patients with acute VBOS treated with EMT in Wuhan No. 1 Hospital were enrolled retrospectively. The demographic and clinical data were collected. According to whether the patients died at 90 d after procedure, they were divided into survival group and death group. The demographic and clinical data were compared between the two groups. Multivariate logistic regression analysis was used to determine the independent risk factors for death at 90 d after EMT.
Results:A total of 47 patients were enrolled. The median age was 62 years, 34 were males (72.3%), the median baseline National Institutes of Health Stroke Scale (NIHSS) score was 16, 42 patients (89.4%) had recanalization (modified Thrombolysis in Cerebral Infarction[mTICI] 2b/3 grade), and 12 (25.5%) died within 90 d after procedure. Univariate analysis showed that the baseline NIHSS score (26 [21-28]vs. 12 [5-23]; Z=-3.165, P=0.002), percentage of neutrophil (81.61% ±11.82% vs. 72.20% ±12.09%; t=-2.137, P=0.033), neutrophil/lymphocyte ratio (10.54±7.17 vs. 4.98±3.57; t=-2.393, P=0.017), and incidence of sICH (25.0% vs. 2.9%; χ2=5.627, P=0.018) in the death group were significantly higher than those in the survival group, while the percentage of lymphocyte (12.00%±9.04% vs. 20.67%±10.39%; t=-2.429, P=0.015) was significantly lower than that of the survival group. Multivariate logistic regression analysis showed that high baseline NIHSS score (odds ratio [OR] 1.243, 95% confidence interval [CI] 1.046-1.318; P=0.038), high neutrophil/lymphocyte ratio (OR 1.278, 95% CI 1.002-1.630; P=0.049) and symptomatic intracranial hemorrhage (OR 5.088, 95% CI 1.065-38.718; P=0.046) were the independent predictors for death.
Conclusion:High baseline NIHSS score, high neutrophil/lymphocyte ratio and symptomatic intracranial hemorrhage are the independent predictors for death within 90 d after EMT in patients with acute VBOS.
