Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke
BackgroundAnemia can occur due to an aspiration maneuver of blood with thrombi during mechanical thrombectomy (MT) for stroke. However, the association between postoperative anemia and stroke outcomes is unknown.MethodsIn a registry-based hospital cohort, consecutive patients with acute ischemic str...
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1299891/full |
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| author | Ryoma Inui Ryoma Inui Junpei Koge Kanta Tanaka Takeshi Yoshimoto Masayuki Shiozawa Soichiro Abe Hiroyuki Ishiyama Hirotoshi Imamura Jin Nakahara Hiroharu Kataoka Masafumi Ihara Kazunori Toyoda Kazunori Toyoda Masatoshi Koga |
| author_facet | Ryoma Inui Ryoma Inui Junpei Koge Kanta Tanaka Takeshi Yoshimoto Masayuki Shiozawa Soichiro Abe Hiroyuki Ishiyama Hirotoshi Imamura Jin Nakahara Hiroharu Kataoka Masafumi Ihara Kazunori Toyoda Kazunori Toyoda Masatoshi Koga |
| author_sort | Ryoma Inui |
| collection | DOAJ |
| description | BackgroundAnemia can occur due to an aspiration maneuver of blood with thrombi during mechanical thrombectomy (MT) for stroke. However, the association between postoperative anemia and stroke outcomes is unknown.MethodsIn a registry-based hospital cohort, consecutive patients with acute ischemic stroke who underwent MT were retrospectively recruited. Patients were divided into the following three groups according to their hemoglobin (Hb) concentrations within 24 h after MT; no anemia (Hb concentrations ≥13 g/dL for men and ≥ 12 g/dL for women), mild anemia (Hb concentrations of 11–13 g/dL and 10–12 g/dL, respectively), and moderate-to-severe anemia (Hb concentrations <11 g/dL and < 10 g/dL, respectively). A 3-month modified Rankin Scale score of 0–2 indicated a favorable outcome.ResultsOf 470 patients, 166 were classified into the no anemia group, 168 into the mild anemia group, and 136 into the moderate-to-severe anemia group. Patients in the moderate-to-severe anemia group were older and more commonly had congestive heart failure than those in the other groups. Patients in the moderate-to-severe anemia group also had more device passes than those in the other groups (p < 0.001). However, no difference was observed in the rate of final extended thrombolysis in cerebral infarction ≥2b reperfusion or intracranial hemorrhage among the groups. A favorable outcome was less frequently achieved in the moderate-to-severe anemia group than in the no anemia group (adjusted odds ratio, 0.46; 95% confidence interval, 0.26–0.81) independent of the baseline Hb concentration. A restricted cubic spline model with three knots showed that the adjusted odds ratio for a favorable outcome was lower in patients with lower Hb concentrations within 24 h after MT.ConclusionModerate-to-severe anemia within 24 h after MT is independently associated with a reduced likelihood of a favorable outcome.Clinical trial registrationhttps://www.clinicaltrials.gov, NCT02251665. |
| first_indexed | 2024-03-08T22:12:25Z |
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| id | doaj.art-7f3c951d8f8348be98e578bd747f4074 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-08T22:12:25Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-7f3c951d8f8348be98e578bd747f40742023-12-19T05:53:30ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-12-011410.3389/fneur.2023.12998911299891Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic strokeRyoma Inui0Ryoma Inui1Junpei Koge2Kanta Tanaka3Takeshi Yoshimoto4Masayuki Shiozawa5Soichiro Abe6Hiroyuki Ishiyama7Hirotoshi Imamura8Jin Nakahara9Hiroharu Kataoka10Masafumi Ihara11Kazunori Toyoda12Kazunori Toyoda13Masatoshi Koga14Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Neurology, Keio University School of Medicine, Tokyo, JapanDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, JapanDivision of Stroke Care Unit, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Neurology, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Neurology, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Neurology, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Neurology, Keio University School of Medicine, Tokyo, JapanDepartment of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Neurology, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Neurology, Keio University School of Medicine, Tokyo, JapanDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, JapanBackgroundAnemia can occur due to an aspiration maneuver of blood with thrombi during mechanical thrombectomy (MT) for stroke. However, the association between postoperative anemia and stroke outcomes is unknown.MethodsIn a registry-based hospital cohort, consecutive patients with acute ischemic stroke who underwent MT were retrospectively recruited. Patients were divided into the following three groups according to their hemoglobin (Hb) concentrations within 24 h after MT; no anemia (Hb concentrations ≥13 g/dL for men and ≥ 12 g/dL for women), mild anemia (Hb concentrations of 11–13 g/dL and 10–12 g/dL, respectively), and moderate-to-severe anemia (Hb concentrations <11 g/dL and < 10 g/dL, respectively). A 3-month modified Rankin Scale score of 0–2 indicated a favorable outcome.ResultsOf 470 patients, 166 were classified into the no anemia group, 168 into the mild anemia group, and 136 into the moderate-to-severe anemia group. Patients in the moderate-to-severe anemia group were older and more commonly had congestive heart failure than those in the other groups. Patients in the moderate-to-severe anemia group also had more device passes than those in the other groups (p < 0.001). However, no difference was observed in the rate of final extended thrombolysis in cerebral infarction ≥2b reperfusion or intracranial hemorrhage among the groups. A favorable outcome was less frequently achieved in the moderate-to-severe anemia group than in the no anemia group (adjusted odds ratio, 0.46; 95% confidence interval, 0.26–0.81) independent of the baseline Hb concentration. A restricted cubic spline model with three knots showed that the adjusted odds ratio for a favorable outcome was lower in patients with lower Hb concentrations within 24 h after MT.ConclusionModerate-to-severe anemia within 24 h after MT is independently associated with a reduced likelihood of a favorable outcome.Clinical trial registrationhttps://www.clinicaltrials.gov, NCT02251665.https://www.frontiersin.org/articles/10.3389/fneur.2023.1299891/fullischemic strokelarge vessel occlusionendovascular therapymechanical thrombectomyanemia |
| spellingShingle | Ryoma Inui Ryoma Inui Junpei Koge Kanta Tanaka Takeshi Yoshimoto Masayuki Shiozawa Soichiro Abe Hiroyuki Ishiyama Hirotoshi Imamura Jin Nakahara Hiroharu Kataoka Masafumi Ihara Kazunori Toyoda Kazunori Toyoda Masatoshi Koga Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke Frontiers in Neurology ischemic stroke large vessel occlusion endovascular therapy mechanical thrombectomy anemia |
| title | Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke |
| title_full | Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke |
| title_fullStr | Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke |
| title_full_unstemmed | Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke |
| title_short | Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke |
| title_sort | detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke |
| topic | ischemic stroke large vessel occlusion endovascular therapy mechanical thrombectomy anemia |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1299891/full |
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