Duanlu Hou1, Chunjie Wang1,2, Xiaofei Ye3, Ping Zhong4, Danhong Wu5. 1. Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, No. 801, Heqing Road, Shanghai, 200240, China. 2. Jiangchuan Community Health Service Center of Minhang District, Shanghai, China. 3. Department of Health Statistics, Second Military Medical University, Shanghai, China. 4. Department of Neurology, Shidong Hospital of Yangpu District, Shanghai, No.999, Shiguang Road, Shanghai, 200438, China. zphgl@163.com. 5. Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, No. 801, Heqing Road, Shanghai, 200240, China. danhongwu@fudan.edu.cn.
Abstract
BACKGROUND: Persistent inflammation is an important driver of disease progression and affects prognosis. Some indicators of inflammation predict short-term outcomes. The relationship between prognosis, especially mortality, and persistent inflammation in massive stroke has not been studied, and this has been the subject of our research. METHODS: From April 1, 2017 to February 1, 2020, consecutive patients were prospectively enrolled. Clinical data, laboratory data, imaging data and follow-up infections morbidity were compared between 2 groups according to modified Rankin scale (mRS) scores (mRS < 3 and ≥ 3) at 1 month. The binomial logistic analysis was used to determine independent factors of 1-month prognosis. Short-term functional outcome, mortality and infection rates in massive stroke with and without persistent inflammation were compared. RESULTS: One hundred thirty-nine patients with massive stroke were included from 800 patients. We found that admission blood glucose levels (p = 0.005), proportions of cerebral hemispheric (p = 0.001), posterior circulatory (p = 0.035), and lacunar (p = 0.022) ischemia were higher in poor outcome patients; neutrophil-to-lymphocyte ratio (odd ratio = 1.87, 95%CI 1.14-3.07, p = 0.013) and blood glucose concentrations (odd ratio = 1.34, 95%CI 1.01-1.79, p = 0.043) can independently predict the short-term prognosis in massive stroke patients. We also found that the incidence of pulmonary infection (p = 0.009), one-month mortality (p = 0.003) and adverse outcomes (p = 0.0005) were higher in patients with persistent inflammation. CONCLUSIONS: This study suggested that persistent inflammation is associated with poor prognosis, 1-month mortality and the occurrence of in-hospital pulmonary infection and that higher baseline inflammation level predicts short-term poor outcomes in massive stroke.
BACKGROUND: Persistent inflammation is an important driver of disease progression and affects prognosis. Some indicators of inflammation predict short-term outcomes. The relationship between prognosis, especially mortality, and persistent inflammation in massive stroke has not been studied, and this has been the subject of our research. METHODS: From April 1, 2017 to February 1, 2020, consecutive patients were prospectively enrolled. Clinical data, laboratory data, imaging data and follow-up infections morbidity were compared between 2 groups according to modified Rankin scale (mRS) scores (mRS < 3 and ≥ 3) at 1 month. The binomial logistic analysis was used to determine independent factors of 1-month prognosis. Short-term functional outcome, mortality and infection rates in massive stroke with and without persistent inflammation were compared. RESULTS: One hundred thirty-nine patients with massive stroke were included from 800 patients. We found that admission blood glucose levels (p = 0.005), proportions of cerebral hemispheric (p = 0.001), posterior circulatory (p = 0.035), and lacunar (p = 0.022) ischemia were higher in poor outcome patients; neutrophil-to-lymphocyte ratio (odd ratio = 1.87, 95%CI 1.14-3.07, p = 0.013) and blood glucose concentrations (odd ratio = 1.34, 95%CI 1.01-1.79, p = 0.043) can independently predict the short-term prognosis in massive strokepatients. We also found that the incidence of pulmonary infection (p = 0.009), one-month mortality (p = 0.003) and adverse outcomes (p = 0.0005) were higher in patients with persistent inflammation. CONCLUSIONS: This study suggested that persistent inflammation is associated with poor prognosis, 1-month mortality and the occurrence of in-hospital pulmonary infection and that higher baseline inflammation level predicts short-term poor outcomes in massive stroke.
Authors: Kaibin Shi; De-Cai Tian; Zhi-Guo Li; Andrew F Ducruet; Michael T Lawton; Fu-Dong Shi Journal: Lancet Neurol Date: 2019-07-08 Impact factor: 44.182
Authors: Thomas Gattringer; Alexandra Posekany; Kurt Niederkorn; Michael Knoflach; Birgit Poltrum; Sebastian Mutzenbach; Hans-Peter Haring; Julia Ferrari; Wilfried Lang; Johann Willeit; Stefan Kiechl; Christian Enzinger; Franz Fazekas Journal: Stroke Date: 2019-02 Impact factor: 7.914
Authors: Philip A Efron; Alicia M Mohr; Azra Bihorac; Hiroyuki Horiguchi; McKenzie K Hollen; Mark S Segal; Henry V Baker; Christiaan Leeuwenburgh; Lyle L Moldawer; Frederick A Moore; Scott C Brakenridge Journal: Surgery Date: 2018-05-26 Impact factor: 3.982
Authors: Elizabeth E Wicks; Kathleen R Ran; Jennifer E Kim; Risheng Xu; Ryan P Lee; Christopher M Jackson Journal: Front Immunol Date: 2022-06-20 Impact factor: 8.786