AUTHOR=Shen Huixin , Ma Qingfeng , Jiao Liqun , Chen Fei , Xue Sufang , Li Jingya , Li Zhengping , Song Haiqing , Huang Xiaoqin 

TITLE=Prognosis and Predictors of Symptomatic Intracranial Hemorrhage After Endovascular Treatment of Large Vessel Occlusion Stroke

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.730940

DOI=10.3389/fneur.2021.730940

ISSN=1664-2295

ABSTRACT=Abstract Background: The symptomatic intracranial hemorrhage (sICH) can be a devastating complication of endovascular treatment (EVT) in acute ischemic stroke (AIS) accompanied by increasing disability and mortality. The aim of this study was to explore the predictors of sICH after EVT in AIS patients with large vessel occlusion (LVO).
Methods: We conducted a retrospective review on consecutive AIS patients underwent EVT in our university hospital between January 2014 and April 2019. Patients were assigned to sICH or without sICH groupThe main outcomes were the occurrence of sICH using the Heidelberg Bleeding Classification and functional condition at 90 d. Multivariate logistic regression analysis and receiver operating characteristics (ROC) curves were used to investigate independent predictors of sICH after EVT.
Results: Three hundred and sixty-nine patients fullilled the inclusion criteria, of which 16.8% (n = 62) developed sICH. Favorable neurological outcome was lower in patients with sICH than in patients without sICH (6.5% vs. 43.3%; P < 0.001) and the overall mortality was 112 (30.4%) at 90 days after EVT. In univariate analysis, significant intergroup differences were found in the prevalence of diabetes, initial ASPECTS score, NIHSS score after operation; The levels of fasting blood glucose (FBG), neutrophil to lymphocyte ratio (NLR), platelets (PLT), and thrombin time (TT) at admission. Multivariate logistic regression analysis showed that FBG ≥ 7.54 mmol/L (OR: 2.765; 95% confidence interval [CI]: 1.513-5.054), NLR ≥ 5.48 (OR: 2.711; 95% CI: 1.433-5.128), TT at admission ≥ 16.25 s (OR: 2.022; 95% CI: 1.115-3.667), NIHSS score after operation within 24 hours ≥ 10 (OR: 3.728; 95% CI: 1.516-9.170) were independent predictors of sICH. When combining NLR ≥ 5.48 with FBG ≥ 7.54 mmol/L, TT at admission ≥ 16.25 s, NIHSS score after operation within 24 hours ≥ 10, the prediction model is optimal (AUC: 0.723).
Conclusion: Higher levels of FDG, NLR, TT at admission and NIHSS score after operation were associated with after EVT sICH in AIS patients with LVO.