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Prognosis of Ischemic Stroke Patients Undergoing Endovascular Thrombectomy is Influenced by Systemic Inflammatory Index Through Malignant Brain Edema

Clinical interventions in aging, 2022-01, Vol.17, p.1001-1012 [Peer Reviewed Journal]

COPYRIGHT 2022 Dove Medical Press Limited ;2022. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2022 Ji et al. 2022 Ji et al. ;ISSN: 1178-1998 ;ISSN: 1176-9092 ;EISSN: 1178-1998 ;DOI: 10.2147/CIA.S365553 ;PMID: 35814350

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Title:
Prognosis of Ischemic Stroke Patients Undergoing Endovascular Thrombectomy is Influenced by Systemic Inflammatory Index Through Malignant Brain Edema
Author: Ji, Yachen ; Xu, Xiangjun ; Wu, Kangfei ; Sun, Yi ; Wang, Hao ; Guo, Yapeng ; Yang, Ke ; Xu, Junfeng ; Yang, Qian ; Huang, Xianjun ; Zhou, Zhiming
Subjects: acute ischemic stroke ; Blood ; Blood platelets ; Blood vessels ; Cardiac arrhythmia ; Care and treatment ; Cerebral edema ; Diabetes ; Diagnosis ; Edema ; endovascular treatment ; Ethylenediaminetetraacetic acid ; Hypertension ; Inflammation ; Ischemia ; Lymphocytes ; malignant cerebral edema ; Medical imaging ; Medical prognosis ; Medical protocols ; Medical research ; Medicine, Experimental ; Neutrophils ; Older people ; Original Research ; Patients ; Prognosis ; Regression analysis ; Risk factors ; Statistical analysis ; Stroke ; Stroke (Disease) ; Stroke patients ; Surgery ; systemic immune inflammatory index ; Variables ; Veins & arteries
Is Part Of: Clinical interventions in aging, 2022-01, Vol.17, p.1001-1012
Description: Purpose: The systemic immune inflammatory index (SII), as a new marker, is widely used to predict the disease prognosis. We investigated the predictive value of SII for malignant cerebral edema (MCE) and whether postoperative MCE mediates the relationship between SII and functional prognosis in patients undergoing endovascular thrombectomy (EVT). Patients and Methods: A total of 829 patients with anterior circulation large-vessel occlusive stroke (LVOS) were registered, and 675 (81.4%) met the inclusion criteria. We collected baseline data upon admission, including SII. Postoperative computed tomography was performed to assess the presence and grading of cerebral edema (CED), and MCE was defined as a CED score of 3. A good prognosis was defined as a modified Rankin Scale (mRS) score of 0-2 at the 90-day follow-up. Results: A total of 132 patients developed MCE after EVT. The patients were divided into MCE and non-MCE groups, and univariate and multifactorial analyses were performed. Among these risk factors, an elevated SII was independently correlated with the occurrence of MCE. In addition, the receiver operating characteristic (ROC) curve was used to assess the predictive capability of SII levels for prognosis. The area under the ROC was 0.69, and the optimal critical value was 2.14. In addition, postoperative MCE may partially account for the poorer functional prognosis of patients with elevated SII (regression coefficient changed by 40.3%). Conclusion: The SII is an independent predictor of malignant brain edema after EVT. Postoperative MCE is partly the reason for the poorer prognosis in patients with elevated SII. Keywords: acute ischemic stroke, endovascular treatment, systemic immune inflammatory index, malignant cerebral edema
Publisher: Auckland: Dove Medical Press Limited
Language: English
Identifier: ISSN: 1178-1998
ISSN: 1176-9092
EISSN: 1178-1998
DOI: 10.2147/CIA.S365553
PMID: 35814350
Source: Directory of Open Access Journals (DOAJ)
Open Access: PubMed Central
AUTh Library subscriptions: ProQuest Central
GFMER Free Medical Journals
Dove Press Free

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Prognosis of Ischemic Stroke Patients Undergoing Endovascular Thrombectomy is Influenced by Systemic Inflammatory Index Through Malignant Brain Edema

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