AUTHOR=Huang Kangmo , Zha Mingming , Xiao Lulu , Gao Jie , Du Juan , Wu Min , Yang Qingwen , Liu Rui , Liu Xinfeng 

TITLE=Prognostic Value of Abnormal Liver Function Tests After Mechanical Thrombectomy for Acute Ischemic Stroke

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.670387

DOI=10.3389/fneur.2021.670387

ISSN=1664-2295

ABSTRACT=Objective
To determine the clinical significance of postoperative abnormal liver function test (ALFT) on the functional outcomes at 90 days in acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT).
Methods
In this retrospective observational study, patients with AIS undergoing MT were enrolled from the Nanjing Stroke Registry Program and the multicenter Captor trial. A favorable outcome was defined as a modified Rankin Scale score 0-2 at 90 days. Predictive models were established by multivariable logistic regression. Improved predictive value of models was assessed by continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Additionally, multivariable logistic regression and restricted cubic spline were used to analyze dose-response correlations between the severity of ALFT and prognosis.
Results
Among 420 patients enrolled, 234 (55.7%) patients were diagnosed as postoperative ALFT after MT. Patients with postoperative ALFT had higher NIHSS score on admission (median, 18 vs. 15, P<0.001) and more pneumonia (65.4% vs. 38.2%, P<0.001) than those without postoperative ALFT. Postoperative ALFT, rather than preoperative ALFT, was independently associated with favorable outcome (adjusted odds ratio, 0.48; 95% confidence interval, 0.28-0.81; P=0.006). The improvement of predictive model after adding postoperative ALFT was significant (continuous NRI [value, 0.401; P<0.001], IDI [value, 0.013; P<0.001]). However, the restricted cubic spline indicated no evidence of a dose-response relationship between the severity of postoperative ALFT and prognosis.
Conclusions
In AIS patients treated by MT, postoperative ALFT was associated with more severe stroke and served as an independent predictor of worse prognosis at 90 days.