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  • Effects of admission systemic inflammatory indicators on clinical outcomes in patients with vertebrobasilar artery occlusion: insight from the PERSIST registry

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Ischemic stroke
Original research
Effects of admission systemic inflammatory indicators on clinical outcomes in patients with vertebrobasilar artery occlusion: insight from the PERSIST registry
  1. Pan Zhang1,
  2. Pengfei Xu1,
  3. Zuowei Duan2,
  4. Feng Zhang1,
  5. Yirong Fang1,
  6. Dingyi Yan1,
  7. Hanhong Zhang1,
  8. Qiankun Cai3,
  9. Xianjun Huang4,
  10. Zhixin Huang5,
  11. Mengmeng Gu6,
  12. Lulu Xiao7,
  13. Jinjing Wang7,
  14. Wen Sun1
  15. on behalf of the PERSIST Investigators
  1. 1 Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
  2. 2 Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
  3. 3 The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
  4. 4 Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, China
  5. 5 Department of Neurology, Guangdong Second Provincial General Hospita, Guangzhou, China
  6. 6 Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
  7. 7 Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
  1. Correspondence to Dr Wen Sun, Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China; sunwen_medneuro{at}163.com; Dr Jinjing Wang, Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China; wangjinjing992{at}163.com

Abstract

Background Few studies have focused on the effect of systemic inflammation in vertebrobasilar artery occlusion (VBAO). The aim of this study was to investigate the relationship between inflammatory indicators and the prognosis of VBAO patients receiving endovascular treatment (EVT).

Method Patients with VBAO who were treated with EVT within 24 hours of the estimated occlusion time were included in this study. Multivariate logistic regression and elastic net regularization were performed to analyze the effects of inflammatory indicators on the prognosis of patients with VBAO. The primary outcome was unfavorable outcome (a modified Rankin Scale score of 4–6) at 90 days. Secondary outcomes included symptomatic intracranial hemorrhage, in-hospital mortality, 90 day mortality, 1 year unfavorable outcome, and mortality.

Results 560 patients were included in the study. Multivariate analysis showed that white blood cells (W), neutrophils (N), neutrophil to lymphocyte ratio (NLR), platelet to neutrophil ratio, platelet to white blood cell ratio, and NLR to platelet ratio were associated with the primary outcome. Elastic net regularization indicated that W, N, and NLR were the major inflammatory predictors of unfavorable outcome at 90 days. For long term prognosis, we found that the inflammatory indicators that predicted 1 year outcomes were consistent with those that predicted 90 day outcomes.

Conclusion Inflammatory indicators, especially W, N, and NLR, were associated with moderate and long term prognosis of patients with VBAO treated with EVT.

  • Stroke
  • Inflammation
  • Inflammatory Response
  • Intervention
  • Artery

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/jnis-2022-019437

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • PZ and PX contributed equally.

    • Contributors The study was conceived by PZ, PX, JW, and WS. PZ prepared the initial draft of the manuscript. PZ and PX carried out the statistical analysis. PZ, JW, and WS revised the manuscript. WS is responsible for the overall content as guarantor. All authors participated in the data collection, analysis, and interpretation. The final version of the manuscript was approved by all authors.

    • Funding The study was supported by grants from Key Research and Development Plan Projects of Anhui Province No 202104j07020049 and Natural Science Foundation of Anhui Province No 2108085MH271.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.