RÉSUMÉ
Objective:To investigate the risk factors of hypoalbuminemia (HA) in patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) after endovascular mechanical thromboectomy (EMT) and impact on outcomes.Methods:Patients first diagnosed with anterior circulation LVO-AIS and underwent emergency EMT at the Department of Acute Stroke, the Affiliated Hospital of Jining Medical University from June 1, 2020 to April 31, 2023 were retrospectively included. According to the first follow-up serum albumin examination after procedure (6-8 d), the patients were divided into HA group (<35 g/L) and non-HA group (≥35 g/L). According to the modified Rankin Scale score at 90 d after EMT, the patients were divided into a good outcome group (0-2) and a poor outcome group (3-6). Univariate and multivariate logistic analysis was used to determine independent risk factors for HA after EMT and their impact on outcomes. Results:A total of 144 patients were enrolled, including 107 males (74.30%) with a median age of 64 years (interquartile range, 56-71 years). There were 50 patients (34.72%) in the HA group and 94 (65.28%) in the non-HA group; 60 (41.67%) in the good outcome group, and 84 (58.33%) in the poor outcome group. Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.061, 95% confidence interval [ CI] 1.014-1.111; P=0.011) and pulmonary infection ( OR 5.136, 95% CI 1.917-13.760; P=0.001) were independent risk factors for HA; HA ( OR 4.345, 95% CI 1.367-13.814; P=0.013), pneumonia ( OR 5.113, 95% CI 1.217-12.528; P=0.026), and onset to reperfusion time ( OR 5.473, 95% CI 1.090-16.05; P=0.038) were independent risk factors for poor outcomes. Conclusions:Age and pulmonary infection are independent risk factors for HA in LVO-ASI patients after EMT, and HA is the independent risk factor for poor outcomes of the patients.
RÉSUMÉ
Objective:To investigate the correlation between serum albumin and hypoalbuminemia (HA) and the outcome after endovascular mechanical thrombectomy (EMT) in patients with stroke caused by acute anterior circulation large vessel occlusion.Methods:Stroke patients caused by acute anterior circulation large vessel occlusion received EMT treatment at the Department of Emergency Stroke, the Affiliated Hospital of Jining Medical University from June 2020 to August 2022 were retrospectively included. The demographic information, baseline clinical data, endovascular treatment parameters, and clinical outcomes of the patients were collected. HA was defined as serum albumin <35 g/L within 24 h of admission, and poor outcome was defined as the modified Rankin Scale score >2 at 90 d after onset. Multivariate logistic regression analysis was used to identify the independent influencing factors for poor outcomes. Results:A total of 177 patients were included, with a median age of 66 years, and 126 (71.19%) were males. Thirty-nine patients (22.03%) had HA, and 119 (67.23%) had poor outcomes. The proportion of pulmonary infection in the HA group was significantly higher than that in the non-HA group ( P<0.05). Multivariate logistic regression analysis showed that lower serum albumin (odds ratio [ OR] 4.102, 95% confidence interval [ CI] 1.316-16.451; P=0.028), postprocedural neurological deterioration ( OR 6.326, 95% CI 1.263-48.318; P=0.042) and pulmonary infection ( OR 5.873, 95% CI 1.028-24.452; P=0.018) were significantly independently associated with the poor outcomes. Conclusions:The HA group has a higher incidence of postprocedural pulmonary infection. Lower serum albumin, postprocedural neurological deterioration and pulmonary infection are the independent risk factors for the poor outcomes in patients with anterior circulation ischemic stroke who had successful recanalization after EMT.
RÉSUMÉ
Objective:To investigate the evaluation value of optical coherence tomography (OCT) for carotid atherosclerotic plaques.Methods:Patients with carotid atherosclerotic stenosis underwent digital subtraction angiography (DSA) and OCT in the Affiliated Hospital of Jining Medical College from January 2020 to January 2022 were retrospectively enrolled. The demographics, baseline clinical data, DSA and OCT imaging data of the symptomatic group and the asymptomatic group were compared. Multivariate logistic regression analysis was used to determine the independent risk factors for symptomatic carotid atherosclerotic stenosis. Results:A total of 39 patients were enrollded, including 21 in the symptomatic group and 18 in the asymptomatic group. The detection rate of fibrous plaque in the symptomatic group was significantly lower than that in the asymptomatic group (38.1% vs. 77.78%; P=0.023), while the detection rate of plaque rupture (38.1% vs. 5.56%; P=0.023) and macrophage infiltration (42.86% vs. 11.11%; P=0.037) was significantly higher than that in the asymptomatic group. Multivariate logistic regression analysis showed that plaque rupture (odds ratio 6.982, 95% confidence interval 1.068-45.660; P=0.043) and macrophage infiltration (odds ratio 6.480, 95% confidence interval 1.009-41.625; P=0.049) were significantly independently associated with the symptomatic carotid atherosclerotic stenosis. Conclusions:OCT is of value in evaluating the plaque characteristics of carotid atherosclerotic stenosis. Plaque rupture and macrophage infiltration are the independent risk factors for symptomatic carotid atherosclerotic stenosis.