Association of Renal Impairment with Clinical Outcomes Following Endovascular Therapy in Acute Basilar Artery Occlusion.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Clinical Interventions in Aging Pub Date : 2024-06-06 eCollection Date: 2024-01-01 DOI:10.2147/CIA.S462638

Xiangping Cheng, Boyu Chen, Xiaoyan Chen, Zhi Song, Jie Li, Jiacheng Huang, Weilin Kong, Jinglun Li

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引用次数: 0

Abstract

Purpose: Renal impairment (RI) is associated with unfavourable outcome after acute ischaemic stroke with anterior circulation large vessel occlusion. We assessed the association of RI with clinical outcomes in patients with acute basilar artery occlusion (ABAO), and the impact of RI on the effects of endovascular therapy (EVT) versus standard medical treatment (SMT).

Patients and methods: We used data from the BASILAR registry, an observational, prospective, nationwide study of patients with ABAO in routine clinical practice in China. Baseline estimated glomerular filtration rate (eGFR) was recorded at admission. The primary outcome was the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included favourable outcome (mRS score 0-3), mortality, and symptomatic intracranial haemorrhage (sICH). Multivariate logistic regression was used to assess the association of RI with mortality and functional improvement at 90 days.

Results: Among 829 patients enrolled, 747 patients were analysed. The median baseline eGFR was 89 mL/min/1.73m² (IQR, 71-100), and 350 (46.8%), 297 (39.8%), and 100 (13.4%) patients had baseline eGFR values of ≥90, 60-89, and <60 mL/min/1.73m², respectively. RI was associated with increased mortality (adjusted odds ratio [aOR], 1.97; 95% CI, 1.15-3.67) at 90 days and decreased survival probability (aOR 1.74; 95% CI, 1.30-2.33) within 1 year. EVT was associated with better functional improvement (common aOR, 2.50; 95% CI, 1.43-4.35), favourable outcome (aOR 5.42; 95% CI, 1.92-15.29) and lower mortality (aOR 0.47; 95% CI, 0.25-0.88) in ABAO patients with eGFR ≥90 mL/min/1.73m². However, RI was not modified the relationship of EVT with functional improvement (common aOR, 3.03; 95% CI, 0.81-11.11), favourable outcome (aOR 2.10; 95% CI, 0.45-9.79), and mortality (aOR 0.56; 95% CI, 0.15-2.06) by eGFR categories.

Conclusion: RI is associated with reduced efficacy of EVT and worse functional outcome and higher mortality at 3 months and lower survival probability at 1 year in patients with ABAO.

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急性基底动脉闭塞症血管内治疗后肾功能损伤与临床结果的关系

目的：肾功能损害（RI）与前循环大血管闭塞性急性缺血性卒中的不良预后有关。我们评估了 RI 与急性基底动脉闭塞（ABAO）患者临床预后的关系，以及 RI 对血管内治疗（EVT）与标准药物治疗（SMT）效果的影响：我们使用了 BASILAR 登记的数据，这是一项针对中国常规临床实践中 ABAO 患者的全国性前瞻性观察研究。入院时记录基线肾小球滤过率（eGFR）。主要结果是90天后的改良Rankin量表（mRS）评分。次要结果包括良好结果（mRS 评分 0-3 分）、死亡率和症状性颅内出血（sICH）。多变量逻辑回归用于评估RI与90天后死亡率和功能改善的关系：在入组的 829 名患者中，对 747 名患者进行了分析。基线 eGFR 中位值为 89 毫升/分钟/1.73 平方米（IQR，71-100），基线 eGFR 值≥90、60-89 和 2 的患者分别为 350 人（46.8%）、297 人（39.8%）和 100 人（13.4%）。RI 与 90 天内死亡率增加（调整后比值比 [aOR]，1.97；95% CI，1.15-3.67）和 1 年内生存概率降低（aOR，1.74；95% CI，1.30-2.33）有关。在 eGFR≥90 mL/min/1.73m2 的 ABAO 患者中，EVT 与更好的功能改善（常见 aOR，2.50；95% CI，1.43-4.35）、良好的预后（aOR，5.42；95% CI，1.92-15.29）和更低的死亡率（aOR，0.47；95% CI，0.25-0.88）相关。然而，RI并未改变EVT与功能改善（常见aOR为3.03；95% CI为0.81-11.11）、良好预后（aOR为2.10；95% CI为0.45-9.79）和死亡率（aOR为0.56；95% CI为0.15-2.06）之间的关系：RI与ABAO患者EVT疗效下降、功能预后较差、3个月死亡率较高和1年生存概率较低有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.80

自引率

2.80%

发文量

193

审稿时长

6-12 weeks

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.