Gao Jie, Zhao Ying, Du Mingyang, Guo Hongquan, Wan Ting, Wu Min, Liu Ling, Wang Huaiming, Yin Qin, Liu Xinfeng
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210000, People's Republic of China.
Cerebrovascular Disease Treatment Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210000, People's Republic of China.
Neuropsychiatr Dis Treat. 2021 Feb 10;17:401-411. doi: 10.2147/NDT.S293771. eCollection 2021.
Albumin levels have been reported to be associated with all-cause and cardiovascular mortality. The aim of this study was to investigate the association between serum albumin and prognosis of ischemic stroke patients after endovascular thrombectomy (EVT) treatment.
Patients with EVT due to large artery occlusion in anterior circulation were selected from ACTUAL (endovascular treatment for acute anterior circulation) ischemic stroke multicenter registry in China. Serum albumin levels were measured within 24 h of admission. The primary outcome was poor functional outcome (modified Rankin scale score of 3-6) at three months. Secondary outcomes were symptomatic intracranial hemorrhage (sICH) and three-month mortality.
A total of 605 patients (mean age, 64.2 years; 59.3% male) were enrolled. Up to three months after stroke, 342 patients (56.5%) developed poor functional outcome. After multivariate adjustment for demographic characteristics, National Institutes of Health stroke score, and other potential confounders, the odds ratio for the lowest tertile of serum albumin levels was 2.43 (95%CI, 1.18-5.01; =0.046) for poor functional outcome, compared with the highest category. Restricted cubic spline regression demonstrated a linear association between albumin levels and poor functional outcome ( for linearity=0.017). Subgroup analyses further confirmed these results. Similar significant findings were also found in the association of serum albumin with mortality, but not with sICH.
Decreased serum albumin levels were independently associated with poor prognosis at 90 days after acute large vessel occlusion stroke in anterior circulation treated with EVT.
据报道，白蛋白水平与全因死亡率和心血管死亡率相关。本研究旨在探讨血清白蛋白与血管内血栓切除术（EVT）治疗后缺血性中风患者预后之间的关联。
从中国ACTUAL（急性前循环血管内治疗）缺血性中风多中心登记处选取因前循环大动脉闭塞接受EVT治疗的患者。入院后24小时内测量血清白蛋白水平。主要结局是三个月时功能预后不良（改良Rankin量表评分为3 - 6分）。次要结局是症状性颅内出血（sICH）和三个月死亡率。
共纳入605例患者（平均年龄64.2岁；59.3%为男性）。中风后三个月内，342例患者（56.5%）出现功能预后不良。在对人口统计学特征、美国国立卫生研究院卒中量表评分和其他潜在混杂因素进行多变量调整后，血清白蛋白水平处于最低三分位数的患者出现功能预后不良的比值比为2.43（95%置信区间，1.18 - 5.01；P = 0.046），与最高类别相比。受限立方样条回归显示白蛋白水平与功能预后不良之间存在线性关联（线性检验P = 0.017）。亚组分析进一步证实了这些结果。在血清白蛋白与死亡率的关联中也发现了类似的显著结果，但与sICH无关。
血清白蛋白水平降低与前循环急性大血管闭塞性中风接受EVT治疗后90天的不良预后独立相关。
