Skeletal muscle quantity predicts short-term outcomes after endovascular thrombectomy for acute stroke due to large-vessel occlusion of the anterior circulation

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-05-24 DOI:10.1016/j.jocn.2025.111345

Keisuke Honma , Tomoyuki Ogino , Masahiro Nagase , Naoki Sasanuma , Yuki Uchiyama , Kazuhisa Domen

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引用次数: 0

Abstract

Objective

Endovascular thrombectomy (EVT) is an essential treatment for large vessel occlusion (LVO) stroke, with expanding indications, including elderly patients and those with extensive ischemic regions. Skeletal muscle mass, a component of frailty, is gaining attention as a potential predictor of EVT outcomes. This study explored the relationship between skeletal muscle mass, assessed by bioelectrical impedance analysis (BIA), and short-term functional prognosis in EVT-treated LVO of anterior-circulation stroke.

Methods

This cohort study included 151 patients who underwent EVT for anterior-circulation LVO between July 2020 and January 2025. Skeletal muscle mass index (SMI) was measured using BIA within 72 h of admission. Functional outcomes were evaluated using the Functional Independence Measure (FIM) at discharge. Multiple regression analysis was performed to identify predictors of FIM, adjusting for age, NIHSS, ASPECTS, mTICI, pre-mRS, and other clinical variables.

Results

In multiple regression models, low SMI was independently associated with lower FIM scores at discharge (β = − 10.255, P = 0.013), alongside age (β = − 0.925, P < 0.001), NIHSS on admission (β = −1.506, P < 0.001), mTICI (β = 7.168, P = 0.027), symptomatic intracranial hemorrhage (β = − 2.982, P = 0.010), and pre-mRS (β = − 5.424, P = 0.030). Logistic regression revealed that older age (odds ratio [OR], 1.088; 95 % confidence interval [95 % CI], 1.040–1.139), higher NIHSS (OR, 1.065; 95 % CI, 1.002–1.132), and lower GNRI (OR, 0.925; 95 % CI, 0.886–0.965) were significantly associated with low skeletal muscle mass during admission.

Conclusion

This study highlights the role of skeletal muscle mass as an independent predictor of short-term prognosis after EVT. BIA-based assessments offer a novel approach to evaluating treatment responsiveness. Enhancing skeletal muscle mass may represent a modifiable factor to improve EVT outcomes, emphasizing the need for further research to validate these findings and explore long-term effects.

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骨骼肌数量预测由于前循环大血管闭塞引起的急性中风血管内取栓后的短期预后

目的血管内血栓切除术（EVT）是大血管闭塞（LVO）脑卒中的重要治疗方法，适应症越来越广泛，包括老年患者和大面积缺血患者。骨骼肌质量是虚弱的一个组成部分，作为EVT结果的潜在预测因素正受到关注。本研究探讨了通过生物电阻抗分析（BIA）评估的骨骼肌质量与evt治疗的前循环卒中LVO的短期功能预后之间的关系。方法本队列研究包括151例在2020年7月至2025年1月期间接受EVT治疗的前循环LVO患者。入院72h内用BIA测定骨骼肌质量指数（SMI）。出院时使用功能独立性量表（FIM）评估功能结局。通过调整年龄、NIHSS、ASPECTS、mTICI、pre-mRS和其他临床变量，进行多元回归分析以确定FIM的预测因子。结果在多元回归模型中，低SMI与出院时较低的FIM评分独立相关（β = - 10.255, P = 0.013），与年龄独立相关(β = - 0.925, P <；0.001)，入院时NIHSS (β = - 1.506, P <；0.001), mTICI(β= 7.168,P = 0.027),症状性颅内出血(β=−2.982,P = 0.010),和pre-mRS(β=−5.424,P = 0.030)。Logistic回归分析结果显示，年龄越大(比值比[OR]， 1.088；95%置信区间[95% CI]， 1.040-1.139)，较高的NIHSS (OR, 1.065；95% CI, 1.002-1.132)， GNRI较低(OR, 0.925；95% CI（0.886-0.965）与入院时骨骼肌质量低显著相关。结论本研究强调骨骼肌质量是EVT术后短期预后的独立预测因子。基于bia的评估提供了一种评估治疗反应性的新方法。增强骨骼肌质量可能是改善EVT结果的一个可改变因素，强调需要进一步研究来验证这些发现并探索长期效果。

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

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.