Total time of operation is a risk factor of stroke-associated pneumonia in acute ischemic stroke patients with intra-arterial treatment

Li, Rui; Li, Wei; Li, Yaoyang; Han, Yaling; Ma, Minmin; Zhu, Wusheng; Li, Min; Dai, Qiliang; Cao, Yuezhou; Xu, Gelin; Liu, Xinfeng

doi:10.1097/md.0000000000003958

Cited by 8 publications

(9 citation statements)

References 31 publications

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“…In accordance with previous studies, our study also found that old age [27], severe neurological deficits [27], high baseline glucose level [28], pneumonia [29,] and sICH [30] were independent predictors for poor functional outcome. Moreover, small baseline infarct core (ASPECTS 8-10) [31], successful revascularization (mTICI 2b-3) [27,32], good collateral status (2-3) [33,34], and OTT ≤6 h [27,35,36] were protective factors.…”

Section: Discussionsupporting

confidence: 79%

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Clinical Effectiveness and Safety Outcomes of Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke in China

Wang²,

Yang³

et al. 2017

Cerebrovasc Dis

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Backgrounds and Purpose: This study was aimed at investigating the outcomes and predictors for the poor functional outcome after endovascular treatment (EVT) in a large, mostly Asian population. Methods: Between January 2014 and June 2016, acute stroke patients with anterior circulation occlusion and EVT were retrospectively enrolled from 21 stroke centers in China. The main outcomes were modified Rankin Scale (0-2 as functional independence, 3-6 as poor) at 90 days, symptomatic intracranial hemorrhage (sICH) at 72 h, and death at 90 days. Logistic regression was used to identify predictors for poor functional outcome at 90 days. Results: Of the 698 patients, 304 (43.6%) patients had functional independence at 90 days. The sICH rate was 15.5% (108/698) and mortality rate at 90 days was 25.4% (177/698). Age (OR 1.04, 95% CI 1.02-1.07), National Institutes of Health Stroke Scale score at admission (11-20 vs. ≤10, OR 2.38, 95% CI 1.23-4.59; ≥21 vs. ≤10, OR 3.66, 95% CI 1.72-7.80), baselineglucose level (OR 1.09, 95% CI 1.01-1.18), onset to groin puncture >6 h (OR 1.88, 95% CI 1.06-3.31), sICH (OR 15.49, 95% CI 5.16-46.43), and pneumonia (OR 3.15, 95% CI 1.86-5.32) were independent predictors of poor functional outcomes, while good recanalization (OR 0.26, 95% CI 0.13-0.54), preoperative Alberta Stroke Program Early CT Score 8-10 (OR 0.48, 95% CI 0.28-0.83), and good collateral flow (OR 0.50, 95% CI 0.32-0.79) were protective factors. Conclusions: This study provides evidence in real world to support the performance of EVT in acute anterior circulation stroke patients in Chinese population. Patients with small infarct core, successful recanalization, good collateral status, and short treatment delay without sICH or pneumonia may benefit from EVT.

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Section: Discussionsupporting

confidence: 79%

“…In our study, all patients were managed in intensive care units after EVT in stroke centers. The previous study showed that the incidence of pneumonia was as high as 57% for patients treated in intensive care units [29]. Also, the post procedural management following EVT was critical and needed more attention in future.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effectiveness and Safety Outcomes of Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke in China

Wang²,

Yang³

et al. 2017

Cerebrovasc Dis

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“…Dysphagia and stroke-induced immunodeficiency were the major risk factors that predispose patients to SAP. [ 22 , 23 ] Besides, age, stroke severity, level of consciousness, chronic obstructive pulmonary disease, and coronary artery disease may be associated with SAP. [ 24 ] Furthermore, a range of research developed some predictive scores based on the risk factors to predictive SAP.…”

Section: Discussionmentioning

confidence: 99%

Stroke-associated pneumonia

et al. 2021

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Stroke-associated pneumonia (SAP) is a spectrum of pulmonary infections in patients within 7 days of stroke. Which is one of the most common complications after stroke and is significantly associated with a poor prognosis of stroke. To the best of our knowledge, a bibliometric method was not previously used to analyze the topic of SAP; we aim to describe the situation and evolution of SAP from 2003 to 2020, and to discuss the research hotspots and frontiers. A total of 151 articles were retrieved from the Scopus database. Bibliometric analysis was used to explore the dynamic trends of articles and the top subject areas, journals, institutes, citations, and co-keywords. VOS viewer software (version 1.6.15) was used to graphically map the hot topics of SAP based on the co-keywords. A total of 151 articles were identified. Articles have increased over the recent years and faster in the last 2 years (55 articles, 36.4%), the majority of subject areas are medicine (124 articles, 82.1%) and neuroscience (38 articles, 25.2%). The “Journal Of Stroke And Cerebrovascular Diseases” with 15 articles has been scored as the first rank followed by “Plos One.” Regarding the geographical distribution of articles, China is the most productive country with 50 articles (33.1%), others are more prominent in Europe, and most institutes are universities. Citations have increased over time, the main country of the top five highly cited published articles are Germany and before 2008. The co-keywords are mainly divided into four aspects: risk factors, predictive scores, preventions, and outcomes. This study could provide practical sources for researchers to find the top subject areas, journals, institutes, citations, and co-keywords. Moreover, the study could pave the way for researchers to be engaged in studies potentially lead to more articles in this field.

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“…The risk of serious adverse events, particularly symptomatic intracerebral hemorrhage is also well known 8 . However, these patients are also prone to medical complications and other adverse events 9‐11 …”

Section: Introductionmentioning

confidence: 99%

Medical complications and outcome after endovascular therapy for acute ischemic stroke

Junttola

Lahtinen

Liisanantti

et al. 2021

Acta Neuro Scandinavica

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Aim Endovascular therapy (EVT) in acute stroke is an effective but invasive treatment which is frequently followed by various complications. The aim of the present study was to examine the rate of medical complications and other adverse events following EVT. Methods Retrospective single‐center study of 380 consecutive stroke patients who received EVT between the years 2015–2019. Results A total of 234 (61.6%) patients had at least one recorded medical complication. The most common complication was pneumonia in 154 (40.5%) patients, followed by acute cardiac insufficiency in 134 (35.3%), and myocardial infarction in 22 (5.8%) patients. In multivariate analysis, the need for general anesthesia (OR 3.8 (1.9–7.7)), Charlson Comorbidity Index >3 (OR 1.3 (1.1–1.5)), male gender (1.9 (1.1–1.3)) and high National Institutes of Health Stroke Scale (NIHSS) score at admission (1.1 (1.0–1.2)) were associated with medical complications. Conclusion Medical complications are common among unselected stroke patients undergoing EVT. Both comorbidity and stroke severity have an influence on medical complications. Early recognition of complications is essential, because vast majority of patients encountering medical complications have a poor short‐term outcome.

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Total time of operation is a risk factor of stroke-associated pneumonia in acute ischemic stroke patients with intra-arterial treatment

Cited by 8 publications

References 31 publications

Clinical Effectiveness and Safety Outcomes of Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke in China

Clinical Effectiveness and Safety Outcomes of Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke in China

Stroke-associated pneumonia

Medical complications and outcome after endovascular therapy for acute ischemic stroke

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