Low-grade inflammation score predicts the outcome of endovascular thrombectomy in patients with anterior circulation large vessel occlusive stroke
10.3760/cma.j.issn.1673-4165.2024.09.001
- VernacularTitle:低度炎症评分预测前循环大血管闭塞性卒中患者血管内治疗后转归
- Author:
Xiao CHEN
1
;
Wei WANG
;
Yong HUANG
;
Yan E
;
Xueting XIN
;
Gang CHEN
Author Information
1. 南通市海门区人民医院神经内科，南通 226100
- Keywords:
Ischemic stroke;
Endovascular procedures;
Thrombectomy;
Inflammation;
C-Reactive protein;
Leukocyte count;
Neutrophils;
Lymphocytes;
Platelet count;
Treatment
- From:
International Journal of Cerebrovascular Diseases
2024;32(9):641-647
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of low-grade inflammation (LGI) score for the outcome of endovascular thrombectomy (EVT) in patients with anterior circulation large vessel occlusive stroke.Methods:Patients with anterior circulation large artery occlusive stroke received EVT at two stroke centers, Nantong Haimen District People's Hospital and Nanjing First Hospital from August 2020 to February 2023 were included retrospectively. The LGI score was calculated based on C-reactive protein, leukocyte count, platelet count, and neutrophil/lymphocyte ratio. At 90 days after onset, the modified Rankin Scale was used for outcome evaluation, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the correlation between LGI scores and outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of LGI score and its individual biomarkers for poor outcome. Results:A total of 575 patients were enrolled, including 326 males (56.7%), aged 70.7±10.8 years. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 14.8±7.4, and the baseline Alberta Stroke Program Early CT Score (ASPECTS) was 8.6±1.1. Two hundred and ten patients (36.5%) received intravenous thrombolysis, 295 (51.3%) had poor collateral circulation, and 505 (87.8%) had successful recanalization. Sixty-five patients (11.3%) experienced symptomatic intracranial hemorrhage (sICH) within 72 hours after EVT, 256 (44.5%) had poor outcome at 90 days after onset, and 88 (15.3%) died within 90 days after onset. Univariate analysis showed that age, hypertension, diabetes, baseline NIHSS score, baseline ASPECTS, LGI score, sICH, stroke etiology classification, baseline blood glucose level, number of attempts to pass, location of occluded vessels, degree of vessel recanalization, and collateral status were associated with the poor outcome (all P<0.05). Multivariate logistic regression analysis showed that high LGI score was the independent predictive factor of poor outcome (odds ratio [ OR] 1.127, 95% confidence interval [ CI] 1.078-1.178; P=0.001), sICH ( OR 1.111, 95% CI 1.053-1.171; P=0.001), and death ( OR 1.120, 95% CI 1.057-1.186; P=0.001). ROC curve analysis showed that the area under the curve of LGI score predicting poor outcome was 0.705 (95% CI 0.663-0.747; P=0.001). The optimal cutoff value was -1.5 points. The sensitivity and specificity were 75.8% and 52.0%, respectively. Conclusions:A higher LGI score is associated with sICH within 72 hours after EVT, and poor outcome and death within 90 days after EVT in patients with anterior circulation large vessel occlusive stroke. LGI score has certain predictive value for the poor outcome after EVT.
