Relationship between carbon dioxide combining power and the short-term prognosis in acute ischemic stroke patients after thrombolysis

Abstract

To investigate the effect of venous blood carbon dioxide binding capacity (CO2-CP) on the short-term prognosis of patients with acute ischemic stroke (AIS) after thrombolytic therapy. A total of 86 AIS inpatients who received thrombolytic therapy in the emergency department of Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from April 2019 to May 2021 were analyzed retrospectively. According to the venous blood CO2-CP levels at admission, the patients were divided into two groups: low CO2-CP group (CO2-CP < 23 mmol/L, n = 52) and high CO2-CP group (CO2-CP ≥ 23 mmol/L, n = 34). The CO2-CP levels and changes between the two groups before and after thrombolytic therapy were compared. The National Institutes of Health Stroke scale (NIHSS) score was used to evaluate the improvement rate of patients after thrombolytic therapy [NIHSS score at admission-NIHSS score at discharge)/NIHSS score at admission ×100%] and in-hospital death was also recorded. The correlation between CO2-CP levels and prognosis of patients with AIS during emergency visit was analyzed, the receiver operator characteristic curve (ROC curve) was drawn and the area under the ROC curve (AUC) was calculated to evaluate the predictive value of CO2-CP in the prognosis of AIS patients. The CO2-CP levels of low CO2-CP group and high CO2-CP group after thrombolytic therapy were significantly higher than those before treatment (mmol/L: 23.08±2.34 vs. 20.46±1.51, 25.24±2.16 vs. 23.94±1.07, both P < 0.05). The differences of CO2-CP before and after treatment in low CO2-CP group were significantly higher than those in high CO2-CP group (mmol/L: 2.62±0.83 vs. 1.30±1.09, P < 0.05). The improvement rate of CO2-CP levels in the high CO2-CP group (NIHSS improvement rate > 45%) was significantly higher than that in the low CO2-CP group [85.29% (29/34) vs. 23.08% (12/52)], while the mortality in the low CO2-CP group was significantly higher than that in the high CO2-CP group [11.54% (6/52) vs. 0% (0/34), P < 0.05]. The AUC of CO2-CP for the prognosis of patients with AIS thrombolysis was 0.820, the 95% confidence interval (95%CI) was 0.727-0.924, P = 0.000 1. AIS patients with CO2-CP levels less than 23 mmol/L have a poor short-term prognosis, which has certain predictive and clinical reference value for choosing thrombolytic time in emergency stroke patients.