Jain Ankita, Aifuwa Eseiwi, Bienenstock Raphael, Kar Shayna, Spirollari Eris, Sacknovitz Ariel, Mashiach Elad, Koyfman Feliks, Chong Ji, Medicherla Chaitanya, Gandhi Chirag D, Al-Mufti Fawaz
School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Department of Neurosurgery, Westchester Medical Center, Valhalla, NY 10595, USA.
Brain Sci. 2025 Apr 8;15(4):386. doi: 10.3390/brainsci15040386.
: Despite advances, large vessel occlusion strokes (LVO) remain associated with significant morbidity. Recent studies have suggested that blood transfusions may help manage critically ill LVO patients. We sought to evaluate the patient characteristics, complications, and clinical outcomes associated with blood transfusions in acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy. : A query of the 2016-2019 National Inpatient Sample was conducted to identify AIS patients who underwent endovascular thrombectomy, using International Classification of Disease 10th Revision diagnostic codes. Demographic, clinical characteristics, severity of presentation, complications, and outcomes were analyzed. Multivariate binary logistic regression was used to assess complications, length of stay (LOS), discharge disposition, and inpatient mortality. : A total of 47,835 AIS patients undergoing endovascular thrombectomy were identified. Of these patients, 1215 (2.5%) received blood transfusions. After controlling for age, gender, National Institutes of Health Stroke Scale scores, Elixhauser Comorbidity Index, and location of stroke, blood transfusions were significant positive predictors for higher rates of inpatient death (OR: 1.96; 95% CI: 1.681, 2.286; < 0.001), lower rates of routine discharge (OR: 0.425; 95% CI: 0.342, 0.527; < 0.001), and prolonged LOS (OR: 2.928; 95% CI: 2.572, 3.333; < 0.001). : Blood transfusions in AIS patients receiving endovascular thrombectomy are associated with elevated complication rates, extended hospital stays, and increased mortality, even after for controlling for predictors of poor outcome. Understanding the broader effects of blood transfusions in AIS patients is essential to ensure that the balance between potential benefits and risks upholds best care practice for all patients.
尽管取得了进展，但大血管闭塞性中风（LVO）仍然与严重的发病率相关。最近的研究表明，输血可能有助于治疗重症LVO患者。我们试图评估接受血管内血栓切除术的急性缺血性中风（AIS）患者输血相关的患者特征、并发症和临床结局。：使用国际疾病分类第10版诊断代码，对2016 - 2019年国家住院患者样本进行查询，以识别接受血管内血栓切除术的AIS患者。分析了人口统计学、临床特征、病情严重程度、并发症和结局。采用多变量二元逻辑回归评估并发症、住院时间（LOS）、出院处置和住院死亡率。：共识别出47835例接受血管内血栓切除术的AIS患者。其中，1215例（2.5%）接受了输血。在控制年龄、性别、美国国立卫生研究院卒中量表评分、埃利克斯豪泽合并症指数和中风部位后，输血是住院死亡率较高（比值比：1.96；95%置信区间：1.681，2.286；P<0.001）、常规出院率较低（比值比：0.425；95%置信区间：0.342，0.527；P<0.001）和住院时间延长（比值比：2.928；95%置信区间：2.572，3.333；P<0.001）的显著正预测因素。：即使在控制了不良结局的预测因素之后，接受血管内血栓切除术的AIS患者输血仍与并发症发生率升高、住院时间延长和死亡率增加相关。了解输血对AIS患者的更广泛影响对于确保潜在益处与风险之间保持平衡以维护所有患者的最佳护理实践至关重要。
