Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland.
J Neurointerv Surg. 2021 Jan;13(1):25-29. doi: 10.1136/neurintsurg-2020-015837. Epub 2020 Apr 17.
Masseter area (MA), a surrogate for sarcopenia, appears to be useful when estimating postoperative survival, but there is lack of consensus regarding the potential predictive value of sarcopenia in acute ischemic stroke (AIS) patients. We hypothesized that MA and density (MD) evaluated from pre-interventional CT angiography scans predict postinterventional survival in patients undergoing mechanical thrombectomy (MT).
312 patients treated with MT for acute occlusions of the internal carotid artery (ICA) or the M1 segment of the middle cerebral artery (M1-MCA) between 2013 and 2018. Median follow-up was 27.4 months (range 0-70.4). Binary logistic (alive at 3 months, OR <1) and Cox regression analyses were used to study the effect of MA and MD averages (MAavg and MDavg) on survival.
In Kaplan-Meier analysis, there was a significant inverse relationship with both MDavg and MAavg and mortality (MDavg P<0.001, MAavg P=0.002). Long-term mortality was 19.6% (n=61) and 3-month mortality 12.2% (n=38). In multivariable logistic regression analysis at 3 months, per 1-SD increase MDavg (OR 0.61, 95% CI 0.41 to 0.92, P=0.018:) and MAavg (OR 0.57, 95% CI 0.35 to 0.91, P=0.019) were the independent predictors associated with lower mortality. In Cox regression analysis, MDavg and MAavg were not associated with long-term survival.
In acute ischemic stroke patients, MDavg and MAavg are independent predictors of 3-month survival after MT of the ICA or M1-MCA. A 1-SD increase in MDavg and MAavg was associated with a 39%-43% decrease in the probability of death during the first 3 months after MT.
咀嚼肌区域（MA），肌少症的替代指标，似乎在评估术后生存方面非常有用，但肌少症在急性缺血性脑卒中（AIS）患者中的潜在预测价值尚未达成共识。我们假设，通过术前 CT 血管造影扫描评估的 MA 和密度（MD）可预测接受机械血栓切除术（MT）的患者的术后生存。
2013 年至 2018 年间，312 例接受 MT 治疗的颈内动脉（ICA）或大脑中动脉 M1 段（M1-MCA）急性闭塞的患者。中位随访时间为 27.4 个月（0-70.4 个月）。采用二元逻辑（3 个月时存活，OR<1）和 Cox 回归分析研究 MA 和 MD 平均值（MAavg 和 MDavg）对生存的影响。
在 Kaplan-Meier 分析中，MDavg 和 MAavg 与死亡率呈显著负相关（MDavg P<0.001，MAavg P=0.002）。长期死亡率为 19.6%（n=61），3 个月死亡率为 12.2%（n=38）。在 3 个月时的多变量逻辑回归分析中，MDavg 每增加 1 个标准差（OR 0.61，95%CI 0.41 至 0.92，P=0.018）和 MAavg（OR 0.57，95%CI 0.35 至 0.91，P=0.019）是与较低死亡率相关的独立预测因子。在 Cox 回归分析中，MDavg 和 MAavg 与长期生存无关。
在急性缺血性脑卒中患者中，MDavg 和 MAavg 是 ICA 或 M1-MCA 接受 MT 后 3 个月生存的独立预测因子。MDavg 和 MAavg 每增加 1 个标准差，与 MT 后前 3 个月内死亡的概率降低 39%-43%相关。
