Universität zu Köln

Borggrefe, Jan ORCID: 0000-0003-2908-7560, Glueck, Berit, Maus, Volker, Onur, Ozgur, Abdullayev, Nuran ORCID: 0000-0003-4522-537X, Barnikol, Utako, Kabbasch, Christoph, Fink, Gereon Rudolf and Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164 (2018). Clinical Outcome After Mechanical Thrombectomy in Patients with Diabetes with Major Ischemic Stroke of the Anterior Circulation. World Neurosurg., 120. S. E212 - 9. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

BACKGROUND: Among patients with acute ischemic stroke treated with mechanical thrombectomy (MT), patients with diabetes (DP) show a poorer outcome compared with patients without diabetes (NDP). This study aims to provide a comprehensive analysis of factors associated with unfavorable outcome in DP receiving MT for stroke of the anterior circulation. METHODS: This study included 317 of 498 consecutive patients who received interventional treatment for acute ischemic stroke in the terminal internal carotid artery and/or middle cerebral artery, including 46 DP. The study data included pre- and posttreatment stroke computed tomography, including perfusion data, collateral status, treatment data including treatment times, pre-existing cardiovascular risk factors, cerebrovascular events, comorbidities, laboratory parameters, and medication. Neurologic status was assessed at baseline (National Institute of Health Stroke Scale [NIHSS]/ modified Rankin Scale [mRS]) and after 90 days (mRS 90). RESULTS: Compared with NDP, DP showed a significantly poorer outcome (mRS90 >2) (P < 0.05). Collateralization and infarct core size did not differ between groups, whereas the penumbra was significantly smaller in DP than in NDP (P < 0.05). The poorer mRS90 outcome (mRS90 > 2) in DP was associated with poor collaterals (P = 0.01) and hyperglycemia on admission (P < 0.05). Shorter time to reperfusion was associated with favorable mRS90 in the NDP (P < 0.001) but not the DP (P = 0.49) group. In uni-variate logistic regression, the following parameters were significantly associated with mRS90: diabetes, hyperglycemia at admission, time to reperfusion, and the NIHSS score (P < 0.05 each). In multivariate analyses and partition regression models of all variables, DP with admission hyperglycemia (>= 132 mg/dl) and older age (>= 66 years) showed a particularly poor outcome. CONCLUSIONS: The main factors for an unfavorable outcome of DP after MT are admission hyperglycemia, age, and NIHSS score.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Glueck, Berit UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Onur, Ozgur UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED orcid.org/0000-0003-4522-537X UNSPECIFIED Barnikol, Utako UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon Rudolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-164503
DOI:	10.1016/j.wneu.2018.08.032
Journal or Publication Title:	World Neurosurg.
Volume:	120
Page Range:	S. E212 - 9
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTERVENTIONAL MANAGEMENT; INTRAVENOUS THROMBOLYSIS; ADMISSION HYPERGLYCEMIA; TIME; REPERFUSION; GLUCOSE; COLLATERALS; ANGIOGRAPHY; ASSOCIATION; PREDICTION Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16450