Mingquan Li1, Yan Chen2, Yanli Zhang3, Xiaoyun Liu3, Tiantian Xie3, Jingjing Yin4, Liumin Wang3, Shucheng Gang3, Jinjin Chen3, Ling Liu5, Fang Yang6, Tongchao Geng7. 1. Department of Neurology, Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210000, China. lmqneurology@163.com. 2. Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210000, China. 3. Department of Neurology, Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210000, China. 4. Geriatric Research Center of Jinling Hospital, Medical School of Nanjing University, Nanjing, China. 5. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210000, China. 6. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210000, China. yangfang021011@163.com. 7. Department of Neurology, Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210000, China. gengtc@tkhealthcare.com.
Abstract
BACKGROUND: Cholinesterase as a sensitive biomarker for prognosis in a variety of conditions but it is rare in stroke studies. The very elderly (≥ 80 years of age) represent the most susceptible group of ischemic stroke. We aimed to determine whether admission serum cholinesterase concentration had any effect on clinical outcome in very elderly patients (individuals aged ≥ 80 years) with acute ischemic stroke. METHODS: A retrospective record review was conducted in two tertiary university hospitals. Elderly patients aged ≥ 80 years admitted with a diagnosis of acute ischemic stroke from January 1, 2014 to November 30, 2019, who had a cholinesterase concentration drawn, were included. The patients were grouped based on the inflection points of the locally weighted regression and smoothing scatterplot (LOESS) curve between cholinesterase levels and in-hospital mortality (study outcome) with lower concentration as reference group. RESULTS: A total of 612 patients were admitted with a diagnosis of acute ischemic stroke, and 569 met the inclusion criteria. A threshold effect was identified using regression smoothing scatterplot (LOESS), with one cutoff point of 4.0 KU/L. There was a significant difference in-hospital mortality was observed (P < 0.001). After adjusted demographic and clinical features, the OR of cholinesterase for mortality was 0.43 (95% CI 0.34-0.54, P < 0.001), suggesting that lower admission cholinesterase level was an independent risk factors for all-cause mortality among patients with AIS. CONCLUSIONS: We have demonstrated a significant association between admission cholinesterase concentration and in-hospital mortality in very elderly patients with AIS.
BACKGROUND: Cholinesterase as a sensitive biomarker for prognosis in a variety of conditions but it is rare in stroke studies. The very elderly (≥ 80 years of age) represent the most susceptible group of ischemic stroke. We aimed to determine whether admission serum cholinesterase concentration had any effect on clinical outcome in very elderly patients (individuals aged ≥ 80 years) with acute ischemic stroke. METHODS: A retrospective record review was conducted in two tertiary university hospitals. Elderly patients aged ≥ 80 years admitted with a diagnosis of acute ischemic stroke from January 1, 2014 to November 30, 2019, who had a cholinesterase concentration drawn, were included. The patients were grouped based on the inflection points of the locally weighted regression and smoothing scatterplot (LOESS) curve between cholinesterase levels and in-hospital mortality (study outcome) with lower concentration as reference group. RESULTS: A total of 612 patients were admitted with a diagnosis of acute ischemic stroke, and 569 met the inclusion criteria. A threshold effect was identified using regression smoothing scatterplot (LOESS), with one cutoff point of 4.0 KU/L. There was a significant difference in-hospital mortality was observed (P < 0.001). After adjusted demographic and clinical features, the OR of cholinesterase for mortality was 0.43 (95% CI 0.34-0.54, P < 0.001), suggesting that lower admission cholinesterase level was an independent risk factors for all-cause mortality among patients with AIS. CONCLUSIONS: We have demonstrated a significant association between admission cholinesterase concentration and in-hospital mortality in very elderly patients with AIS.
Entities:
Keywords:
Acute ischemic stroke; Cholinesterase; In-hospital mortality; Very elderly patients
Authors: Tiffany E Chang; Xin Tong; Mary G George; Sallyann M Coleman King; Xiaoping Yin; Suzanne O'Brien; Ghada Ibrahim; Alice Liskay; Jennifer L Wiltz Journal: Stroke Date: 2019-06-18 Impact factor: 7.914
Authors: Michael G Shlipak; Kunihiro Matsushita; Johan Ärnlöv; Lesley A Inker; Ronit Katz; Kevan R Polkinghorne; Dietrich Rothenbacher; Mark J Sarnak; Brad C Astor; Josef Coresh; Andrew S Levey; Ron T Gansevoort Journal: N Engl J Med Date: 2013-09-05 Impact factor: 91.245
Authors: E Murat Arsava; Johanna Helenius; Ross Avery; Mine H Sorgun; Gyeong-Moon Kim; Octavio M Pontes-Neto; Kwang Yeol Park; Jonathan Rosand; Mark Vangel; Hakan Ay Journal: JAMA Neurol Date: 2017-04-01 Impact factor: 18.302
Authors: William J Powers; Colin P Derdeyn; José Biller; Christopher S Coffey; Brian L Hoh; Edward C Jauch; Karen C Johnston; S Claiborne Johnston; Alexander A Khalessi; Chelsea S Kidwell; James F Meschia; Bruce Ovbiagele; Dileep R Yavagal Journal: Stroke Date: 2015-06-29 Impact factor: 10.170
Authors: Patrick Naumann; Jonathan Eberlein; Benjamin Farnia; Jakob Liermann; Thilo Hackert; Jürgen Debus; Stephanie E Combs Journal: Cancers (Basel) Date: 2019-10-26 Impact factor: 6.639