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Relationship between estimated glomerular filtration rate and outcome of ischemic stroke patients after mechanical thrombectomy
- Source :
- CNS Neuroscience & Therapeutics
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Aims We aimed to determine whether preprocedural renal function affects the outcome of acute ischemic stroke (AIS) patients with mechanical thrombectomy (MT) and whether this effect is modified by the onset‐to‐reperfusion time (OTR) and mediated by collateral status. Methods Eligible patients with anterior circulation large vessel occlusion (LVO) who underwent MT between August 2018 and August 2020 were reviewed. The main outcome was good functional outcome [defined as modified Rankin Scale (mRS) of 0–2] at 3 months. Multivariable logistic regression analyses were conducted to explore the relationship between renal function and good functional outcome. A moderation analysis and the Johnson‐Neyman technique were performed to assess the interaction between renal function and OTR to predict the outcome of AIS patients with MT. Results Among 100 enrolled patients, 36 (36%) exhibited good functional outcome. A decreased preprocedural estimated glomerular filtration rate (pre‐eGFR) was significantly associated with worse functional outcome [adjusted OR, 1.059 (1.012–1.108); p, 0.014], and this effect was partly mediated by collateral circulation. An interaction between OTR and pre‐eGFR on functional outcome was observed (P for interaction, 0.22), and pre‐eGFR only had a significant effect on functional outcome when OTR exceeded 455.8 min. Moreover, the adverse effect of OTR on functional outcome became no longer significant when the pre‐eGFR was higher than 89.0 mL/min/1.73 mL/min/1.73 m². Conclusions Renal function was related to functional outcome at 3 months, and this relationship could be modified by OTR. The results suggested that reducing OTR and improving collateral circulation may mitigate the adverse effect of reduced kidney function on functional outcome.<br />The relationship between preoperative estimated glomerular filtration rate and functional outcome varies according to the onset‐to‐reperfusion time, reducing OTR may mitigate the negative effect of renal dysfunction.
- Subjects :
- Male
acute ischemic stroke
medicine.medical_specialty
Computed Tomography Angiography
Collateral Circulation
Renal function
Kidney Function Tests
Logistic regression
Outcome (game theory)
mechanical thrombectomy
Predictive Value of Tests
Modified Rankin Scale
Physiology (medical)
Internal medicine
medicine
Humans
Pharmacology (medical)
Registries
Adverse effect
Acute ischemic stroke
Aged
Ischemic Stroke
Retrospective Studies
Thrombectomy
Aged, 80 and over
Pharmacology
business.industry
renal function
Original Articles
Recovery of Function
Middle Aged
Collateral circulation
Mechanical thrombectomy
Psychiatry and Mental health
Treatment Outcome
Reperfusion
Cardiology
Original Article
time window
Female
business
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 17555949 and 17555930
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- CNS Neuroscience & Therapeutics
- Accession number :
- edsair.doi.dedup.....dccc3dc5149143b9c99b45d24b916cb8