ArticleBMC neurology2024
The joint effects of inflammation and renal function status on in-hospital outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis.
Article in BMC neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Pre-Thrombolysis Biological Correlates of Admission Glasgow Coma Scale in Older Adults with Acute Ischemic Stroke: A Retrospective Single-Center Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
- Reply to the Letter Regarding: "Intravenous Tirofiban for Preventing Acute In-Stent Thrombosis in Emergent Carotid Artery Stenting".Clinical neuroradiology · 2026Article
- Exploring Facial Nucleus-Centered Connectivity in Hemifacial Spasm: Novel Insights into Pathogenesis and Surgical Impact.Brain topography · 2025Article
- Cerebrovascular and Peripheral Vascular Complications in Cancer Patients.Current neurology and neuroscience reports · 2025Review
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Authors and funding
8 authors.
Funding
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Abstract
objectiveWe aimed to determine the predictive value of renal function status [estimating glomerular filtration rate (eGFR)] in conjunction with inflammatory biomarkers [white blood cell(WBC) and C-reactive protein (CRP)] for in-hospital outcomes in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT).
methodsWe retrospectively screened a total of 409 AIS patients treated with IVT. The study participants were classified into two groups according to post-stroke pneumonia or functional outcome. They were divided into four groups according to the cut-offs of inflammatory biomarkers and eGFR by receiver operating characteristics(ROC) curves for two outcomes of post-stroke pneumonia and functional status: WBC↓/eGFR↑, WBC↓/eGFR↓, WBC↑/eGFR↑, and WBC↑/eGFR↓for post-stroke pneumonia; and CRP↓/eGFR↑, CRP↓/eGFR↓, CRP↑/eGFR↑, and CRP↑/eGFR↓for functional outcome. Logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of post-stroke pneumonia or at-discharge functional outcome, using the WBC↓/eGFR↑group or CRP↓/eGFR↑group as the reference. The Net Reclassification Index (NRI) and the Integrated Discrimination Improvement (IDI) were calculated to analyze the combined predictive value.
resultsCompared with patients in WBC↓/eGFR↑group, those in WBC↑/eGFR↑group had increased risk of post-stroke pneumonia (OR 5.15, 95% CI 1.67-15.87) and poor functional outcome (OR 5.95, 95% CI 2.25-15.74). Furthermore, patients in WBC↑/ eGFR↓group had the highest risk of clinical outcomes (all P value for trend < 0.001), the multivariable-adjusted ORs (95% CIs) were 7.04 (2.42-20.46) for post-stroke pneumonia and 8.64 (3.30-22.65) for poor functional outcome. The addition of WBC and eGFR to the basic model significantly improved risk prediction for post-stroke pneumonia (category-free NRI 69.0%, 95% CI 47.3%-90.7%; IDI 5.4%, 95% CI 2.6%-8.3%) and functional outcome (category-free NRI 59.4%, 95% CI 39.2%-79.9%; IDI 5.3%, 95% CI 2.9%-7.8%). Similarly, when we added CRP and eGFR to the basic model with conventional risk factors, the risk discrimination and prediction for post-stroke pneumonia and functional outcome was also significantly improved.
conclusionCombining renal function status and inflammatory biomarkers within 4.5 h after onset could better predict in-hospital outcomes of AIS patients with IVT.
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