Association between Peripheral Arterial Lactate Levels and Malignant Brain Edema Following Endovascular Treatment for Ischemic Stroke

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Current neurovascular research Pub Date : 2023-12-15 DOI:10.2174/0115672026283642231212061910

Huiyuan Wang, Ruozhen Yuan, Panpan Shen, Xinyue Yu, Xinyi Chen, Yafei Shang, Jie Xu, Mingming Tan, Sheng Zhang, Yu Geng

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Abstract

Aims: To investigate the factors of postoperative malignant brain edema (MBE) in patients with acute ischemic stroke (AIS) treated with endovascular treatment (EVT). Background: MBE is a severe complication following EVT for AIS, and it is essential to identify risk factors early. Peripheral arterial lactate (PAL) levels may serve as a potential predictive marker for MBE. Objective: To determine whether immediate postoperative PAL levels and the highest PAL level within 24 hours of EVT are independently associated with MBE development in AIS patients. Methods: We retrospectively analyzed patients with AIS who underwent EVT from October 2019 to October 2022. Arterial blood was collected every 8 h after EVT to measure PAL, and record the immediate postoperative PAL and the highest PAL level within 24 h. Brain edema was evaluated using brain computed tomography scans within 7 days of EVT. Results: The study included 227 patients with a median age of 71 years, of whom 59.5% were male and MBE developed in 25.6% of patients (58/227). Multivariate logistic regression analysis showed that the immediate postoperative PAL (odds ratio, 1.809 [95% confidence interval (CI), 1.215-2.693]; p = 0.004) and the highest PAL level within 24 h of EVT (odds ratio, 2.259 [95% CI, 1.407-3.629]; p = 0.001) were independently associated with MBE. The area under the curve for predicting MBE based on the highest PAL level within 24 hours of EVT was 0.780 (95% CI, 0.711-0.849). Conclusion: Early increase in PAL levelsis an independent predictor of MBE after EVT in AIS patients.

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缺血性脑卒中血管内治疗后外周动脉乳酸水平与恶性脑水肿之间的关系

目的：研究接受血管内治疗（EVT）的急性缺血性卒中（AIS）患者术后恶性脑水肿（MBE）的因素。背景：MBE是EVT治疗AIS后的一种严重并发症，及早识别风险因素至关重要。外周动脉乳酸（PAL）水平可作为 MBE 的潜在预测指标。目的确定术后即刻的 PAL 水平和 EVT 24 小时内的最高 PAL 水平是否与 AIS 患者发生 MBE 独立相关。方法：我们对 AIS 患者进行了回顾性分析：我们回顾性分析了2019年10月至2022年10月期间接受EVT的AIS患者。EVT后每隔8小时采集动脉血以测量PAL，并记录术后即刻的PAL和24小时内的最高PAL水平。研究结果研究共纳入 227 名患者，中位年龄为 71 岁，其中 59.5% 为男性，25.6% 的患者（58/227）出现 MBE。多变量逻辑回归分析显示，术后即刻的 PAL（几率比，1.809 [95% 置信区间 (CI)，1.215-2.693]；p = 0.004）和 EVT 24 小时内的最高 PAL 水平（几率比，2.259 [95% CI，1.407-3.629]；p = 0.001）与 MBE 独立相关。根据 EVT 24 小时内的最高 PAL 水平预测 MBE 的曲线下面积为 0.780（95% CI，0.711-0.849）。结论PAL水平的早期升高是预测AIS患者EVT后MBE的独立指标。

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来源期刊

Current neurovascular research 医学-临床神经学

CiteScore

3.80

自引率

9.50%

发文量

审稿时长

3 months

期刊介绍： Current Neurovascular Research provides a cross platform for the publication of scientifically rigorous research that addresses disease mechanisms of both neuronal and vascular origins in neuroscience. The journal serves as an international forum publishing novel and original work as well as timely neuroscience research articles, full-length/mini reviews in the disciplines of cell developmental disorders, plasticity, and degeneration that bridges the gap between basic science research and clinical discovery. Current Neurovascular Research emphasizes the elucidation of disease mechanisms, both cellular and molecular, which can impact the development of unique therapeutic strategies for neuronal and vascular disorders.