Zhiwei Gu, Aiqin Yin, Li Lu, Yi Lu, Bei Jiang, Limin Yin
{"title":"接受血管介入治疗的急性脑缺血患者术中低氧血症的风险因素及其对预后的影响：一项回顾性队列研究。","authors":"Zhiwei Gu, Aiqin Yin, Li Lu, Yi Lu, Bei Jiang, Limin Yin","doi":"10.4103/bc.bc_50_23","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute cerebral infarction (ACI) is one of the most common ischemic cerebrovascular diseases in neurology, with high morbidity, mortality, and disability. Early thrombolytic treatment of ACI has significant efficacy, but intraprocedural complications of hypoxemia can significantly reduce the efficacy. This study aims to analyze the risk factors for intraprocedural hypoxemia in patients with ACI, so as to take effective measures in advance to reduce the likelihood of adverse patient outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed a total of 238 patients with ACI treated with vascular interventions from May 2017 to May 2022. To assess and collate the patients' characteristics, factors associated with the development of intraprocedural hypoxemia. The independent risk factors for the development of intraprocedural hypoxemia were analyzed by binary logistic regression.</p><p><strong>Results: </strong>A total of 238 patients were included in this study. Of these, intraprocedural hypoxemia occurred in 89 (37.4%). The results showed that old age (odds ratio [OR] = 2.666, <i>P</i> = 0.009), obesity (OR = 3.029, <i>P</i> = 0.003), smoking history (OR = 2.655, <i>P</i> = 0.010), preoperative oxygen saturation (SpO<sub>2</sub>) (OR = 0.001, <i>P</i> = 0.042), preoperative C-reactive protein (OR = 1.216, <i>P</i> = 0.002), and time from puncture to vascular recanalization (OR = 1.135, <i>P</i> = 0.000) were independent risk factors for intraprocedural hypoxemia in patients. The prognosis of the patients was assessed according to the modified Rankin scale, and the prognosis of the nonhypoxemia group was significantly better than that of the hypoxemia group. Regression analysis showed that intraprocedural hypoxemia (OR = 0.360, <i>P</i> = 0.001), postoperative lower extremity vein thrombosis (OR = 0.187, <i>P</i> = 0.018), hydrocephalus (OR = 0.069, <i>P</i> = 0.015), intracranial hemorrhage (OR = 0.116, <i>P</i> = 0.002), and reocclusion (OR = 0.217, <i>P</i> = 0.036) were independent risk factors for poor prognosis.</p><p><strong>Conclusions: </strong>Currently, intravascular hypoxemia in patients with ACI has a serious impact on prognosis. Clinical work should attach great importance to the clinical characteristics of patients, identify relevant risk factors, and aggressively take personalized therapeutic actions to improve patients' prognosis.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034448/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk factors for intraprocedural hypoxemia in patients with acute cerebral ischemia treated with vascular intervention and its impact on prognosis: A retrospective cohort study.\",\"authors\":\"Zhiwei Gu, Aiqin Yin, Li Lu, Yi Lu, Bei Jiang, Limin Yin\",\"doi\":\"10.4103/bc.bc_50_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Acute cerebral infarction (ACI) is one of the most common ischemic cerebrovascular diseases in neurology, with high morbidity, mortality, and disability. Early thrombolytic treatment of ACI has significant efficacy, but intraprocedural complications of hypoxemia can significantly reduce the efficacy. This study aims to analyze the risk factors for intraprocedural hypoxemia in patients with ACI, so as to take effective measures in advance to reduce the likelihood of adverse patient outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed a total of 238 patients with ACI treated with vascular interventions from May 2017 to May 2022. To assess and collate the patients' characteristics, factors associated with the development of intraprocedural hypoxemia. The independent risk factors for the development of intraprocedural hypoxemia were analyzed by binary logistic regression.</p><p><strong>Results: </strong>A total of 238 patients were included in this study. Of these, intraprocedural hypoxemia occurred in 89 (37.4%). The results showed that old age (odds ratio [OR] = 2.666, <i>P</i> = 0.009), obesity (OR = 3.029, <i>P</i> = 0.003), smoking history (OR = 2.655, <i>P</i> = 0.010), preoperative oxygen saturation (SpO<sub>2</sub>) (OR = 0.001, <i>P</i> = 0.042), preoperative C-reactive protein (OR = 1.216, <i>P</i> = 0.002), and time from puncture to vascular recanalization (OR = 1.135, <i>P</i> = 0.000) were independent risk factors for intraprocedural hypoxemia in patients. The prognosis of the patients was assessed according to the modified Rankin scale, and the prognosis of the nonhypoxemia group was significantly better than that of the hypoxemia group. Regression analysis showed that intraprocedural hypoxemia (OR = 0.360, <i>P</i> = 0.001), postoperative lower extremity vein thrombosis (OR = 0.187, <i>P</i> = 0.018), hydrocephalus (OR = 0.069, <i>P</i> = 0.015), intracranial hemorrhage (OR = 0.116, <i>P</i> = 0.002), and reocclusion (OR = 0.217, <i>P</i> = 0.036) were independent risk factors for poor prognosis.</p><p><strong>Conclusions: </strong>Currently, intravascular hypoxemia in patients with ACI has a serious impact on prognosis. Clinical work should attach great importance to the clinical characteristics of patients, identify relevant risk factors, and aggressively take personalized therapeutic actions to improve patients' prognosis.</p>\",\"PeriodicalId\":9288,\"journal\":{\"name\":\"Brain Circulation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-03-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034448/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brain Circulation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/bc.bc_50_23\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain Circulation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/bc.bc_50_23","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Risk factors for intraprocedural hypoxemia in patients with acute cerebral ischemia treated with vascular intervention and its impact on prognosis: A retrospective cohort study.
Background: Acute cerebral infarction (ACI) is one of the most common ischemic cerebrovascular diseases in neurology, with high morbidity, mortality, and disability. Early thrombolytic treatment of ACI has significant efficacy, but intraprocedural complications of hypoxemia can significantly reduce the efficacy. This study aims to analyze the risk factors for intraprocedural hypoxemia in patients with ACI, so as to take effective measures in advance to reduce the likelihood of adverse patient outcomes.
Methods: We retrospectively analyzed a total of 238 patients with ACI treated with vascular interventions from May 2017 to May 2022. To assess and collate the patients' characteristics, factors associated with the development of intraprocedural hypoxemia. The independent risk factors for the development of intraprocedural hypoxemia were analyzed by binary logistic regression.
Results: A total of 238 patients were included in this study. Of these, intraprocedural hypoxemia occurred in 89 (37.4%). The results showed that old age (odds ratio [OR] = 2.666, P = 0.009), obesity (OR = 3.029, P = 0.003), smoking history (OR = 2.655, P = 0.010), preoperative oxygen saturation (SpO2) (OR = 0.001, P = 0.042), preoperative C-reactive protein (OR = 1.216, P = 0.002), and time from puncture to vascular recanalization (OR = 1.135, P = 0.000) were independent risk factors for intraprocedural hypoxemia in patients. The prognosis of the patients was assessed according to the modified Rankin scale, and the prognosis of the nonhypoxemia group was significantly better than that of the hypoxemia group. Regression analysis showed that intraprocedural hypoxemia (OR = 0.360, P = 0.001), postoperative lower extremity vein thrombosis (OR = 0.187, P = 0.018), hydrocephalus (OR = 0.069, P = 0.015), intracranial hemorrhage (OR = 0.116, P = 0.002), and reocclusion (OR = 0.217, P = 0.036) were independent risk factors for poor prognosis.
Conclusions: Currently, intravascular hypoxemia in patients with ACI has a serious impact on prognosis. Clinical work should attach great importance to the clinical characteristics of patients, identify relevant risk factors, and aggressively take personalized therapeutic actions to improve patients' prognosis.
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