Liu Juan, Zhang Min, Huang Jiandi, Guo Changwei, Yang Jie, Yue Chengsong, Zi Wenjie, Yang Qingwu
Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, People's Republic of China.
Department of Neurology, Jiangmen Central Hospital, Jiangmen, People's Republic of China.
Clin Interv Aging. 2024 Apr 17;19:627-638. doi: 10.2147/CIA.S453268. eCollection 2024.
Acute ischemic stroke (AIS) stands as the primary cause of mortality and extended disability globally. While prior studies have examined the connection between stroke and local weather, they have produced conflicting results. Our goal was to examine the correlation between temperature and functional prognosis in patients with large vessel occlusion (LVO) undergoing endovascular therapy (EVT).
This study included a total of 1809 patients. Temperatures from stroke onset to groin puncture were categorized into Cold (10th percentile of temperature), Cool (10th-50th percentile of temperature), Warm (50th-90th percentile of temperature), and Hot (90th percentile of temperature) groups. The primary efficacy result was the modified Rankin Scale (mRS) score at 90 days. Safety outcomes included mortality, symptomatic intracranial hemorrhage (sICH) and complications after cerebral infarction.
The primary efficacy results demonstrated a statistical enhancement in functional outcomes at 90 days for patients in the Warm group compared to the Cold group (adjusted common odds ratio [OR]: 1.386; 95% confidence interval [CI]: 1.024-1.878, P=0.035). Secondary efficacy results showed that temperature was associated with a higher rate of 90-day functional independence (adjusted OR: 1.016; 95% CI: 1.004-1.029; P=0.009), which was higher in the Warm group compared with patients in the Cold group (adjusted OR: 1.646; 95% CI: 1.107-2.448, P=0.014). There were no significant differences between groups in terms of sICH, 90-day mortality, and post-infarction complications.
Compared with Cold temperature, Warm temperature is associated with better functional outcomes and reduced mortality risk without increasing the risk of sICH.
急性缺血性卒中（AIS）是全球范围内致死和导致长期残疾的主要原因。虽然先前的研究探讨了卒中与当地天气之间的联系，但结果相互矛盾。我们的目标是研究接受血管内治疗（EVT）的大血管闭塞（LVO）患者的体温与功能预后之间的相关性。
本研究共纳入1809例患者。将卒中发作至腹股沟穿刺时的体温分为冷（第10百分位数体温）、凉（第10 - 50百分位数体温）、暖（第50 - 90百分位数体温）和热（第90百分位数体温）组。主要疗效结果是90天时的改良Rankin量表（mRS）评分。安全性结局包括死亡率、症状性颅内出血（sICH）和脑梗死后并发症。
主要疗效结果显示，与冷组相比，暖组患者90天时的功能结局有统计学上的改善（调整后的共同比值比[OR]：1.386；95%置信区间[CI]：1.024 - 1.878，P = 0.035）。次要疗效结果表明，体温与90天功能独立率较高相关（调整后的OR：1.016；95% CI：1.004 - 1.029；P = 0.009），与冷组患者相比，暖组患者的该比率更高（调整后的OR：1.646；95% CI：1.107 - 2.448，P = 0.014）。在sICH、90天死亡率和梗死后并发症方面，各组之间无显著差异。
与低温相比，温暖的温度与更好的功能结局和降低的死亡风险相关，且不增加sICH风险。
