Perioperative risk factors associated with prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy

Abstract

Objective To investigate the perioperative risk factors associated with prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy under general anesthesia. Methods The clinical data of 108 patients with acute ischemic stroke, admitted to and accepted mechanical thrombectomy under general anesthesia in our hospital from January 1, 2016 to October 31, 2018, were collected. According to modified Rankin scale (mRS) scores 90 d after surgery, patients were divided into good prognosis group (mRS scores≤2) and poor prognosis group (mRS scores ≥3). Univariate analysis was used to compare the general data (age, gender, body mass index, and underlying diseases) and perioperative conditions (immediate heart rate, systolic and diastolic blood pressures immediately after admission, operative time, and anesthesia time) between the two groups of patients. Multivariate Logistic regression analysis was used to identify the perioperative risk factors influencing the prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy. Results Among the 108 patients, 65 had good prognosis and 43 had poor prognosis. Univariate analysis showed that there was no significant difference in general data between the two groups (P>0.05), but there were significant differences in heart rate immediately after admission, National Institutes of Health Stroke Scale (NIHSS) scores immediately after admission and 3 d after operation, maximum hemoglobin and blood glucose values from immediately after admission to 3rd d of operation, and thrombolysis in myocardial infarction (TIMI) blood flow classification (P<0.05). Multivariate Logistic regression analysis showed that heart rate immediately after admission (OR=1.035, 95%CI: 1.002-1.067, P=0.037) and NIHSS scores 3 d after operation (OR=1.153, 95%CI: 1.016-1.272, P=0.030) were the perioperative risk factors influencing the prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy. Conclusion For patients with acute ischemic stroke who have rapid heart rate immediately after admission and high NIHSS scores 3 d after mechanical thrombectomy, possibility of poor prognosis should be noticed. Key words: Acute ischemic stroke; Mechanical thrombectomy; General anesthesia; Prognosis; Perioperative period; Risk factor