Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Department of Neurology, Nanchong Central Hospital/The Second Clinical Medical College of North Sichuan Medical University, Sichuan, China.
Department of Neurology, Tianjin Third Central Hospital, Tianjin, China.
J Stroke Cerebrovasc Dis. 2024 Nov;33(11):107925. doi: 10.1016/j.jstrokecerebrovasdis.2024.107925. Epub 2024 Aug 10.
To investigate the association between intracranial hemorrhage (ICH) and preoperative levels of neutrophils and low-density lipoprotein-cholesterol (LDL-C) in acute ischemic stroke (AIS) patients following endovascular thrombectomy (EVT), and to assess the predictive value of preoperative levels of neutrophils and LDL-C.
A retrospective analysis was performed on the clinical records of patients diagnosed with AIS who underwent EVT at Nanchong Central Hospital between 2019 and 2023. Multivariate regression analysis was employed to examine the association of preoperative levels of neutrophils and LDL-C with the occurrence of ICH. Furthermore, a receiver operating characteristic curve was constructed to assess the predictive efficacy of these parameters.
A total of 300 patients with a mean age of 68.0 years (standard deviation, 11.1 years) and a median baseline National Institutes of Health Stroke scale (NIHSS) score of 15.5 (interquartile range, 12.0-19.75) were identified in this cohort. Of these, 28 (9.3%) patients experienced ICH. Multivariate regression analysis revealed that elevated preoperative neutrophil (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.38, P < 0.001) and LDL-C (OR 2.64, 95% CI 1.52-4.58, P < 0.001) levels were independently associated with ICH. The combined indicator demonstrated a higher area under the curve (AUC 0.759, 95% CI 0.654-0.865) compared with preoperative neutrophil (AUC 0.647, 95% CI 0.532-0.763) and LDL-C (AUC 0.711, 95% CI 0.607-0.814) levels individually.The specificity and sensitivity of the combined indicator were 67.9% and 83.1%, respectively.
Preoperative levels of neutrophils and LDL-C may serve as predictive indicators for ICH in patients with AIS who have undergone EVT; moreover, the combination of preoperative neutrophil and LDL-C levels demonstrates enhanced predictive efficacy.
探讨急性缺血性脑卒中（AIS）患者血管内血栓切除术（EVT）后颅内出血（ICH）与术前中性粒细胞和低密度脂蛋白胆固醇（LDL-C）水平之间的关系，并评估术前中性粒细胞和 LDL-C 水平的预测价值。
对 2019 年至 2023 年在南充市中心医院接受 EVT 治疗的 AIS 患者的临床记录进行回顾性分析。采用多变量回归分析探讨术前中性粒细胞和 LDL-C 水平与 ICH 发生的相关性。此外，还构建了受试者工作特征曲线来评估这些参数的预测效能。
该队列共纳入 300 例平均年龄 68.0 岁（标准差 11.1 岁）、基线国立卫生研究院卒中量表（NIHSS）评分中位数为 15.5（四分位距 12.0-19.75）的患者，其中 28 例（9.3%）患者发生 ICH。多变量回归分析显示，术前升高的中性粒细胞（比值比[OR] 1.23，95%置信区间[CI] 1.10-1.38，P<0.001）和 LDL-C（OR 2.64，95%CI 1.52-4.58，P<0.001）水平与 ICH 独立相关。联合指标的曲线下面积（AUC）为 0.759（95%CI 0.654-0.865），高于术前中性粒细胞（AUC 0.647，95%CI 0.532-0.763）和 LDL-C（AUC 0.711，95%CI 0.607-0.814）水平。联合指标的特异性和敏感性分别为 67.9%和 83.1%。
术前中性粒细胞和 LDL-C 水平可能是 EVT 治疗 AIS 患者 ICH 的预测指标；此外，术前中性粒细胞和 LDL-C 水平的联合指标具有增强的预测效能。
