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Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients

OBJECTIVE: To investigate the difference in early edema, quantified by net water uptake (NWU) based on computed tomography (CT) between ischemic core and penumbra and to explore predictors of NWU and test its predictive power for clinical outcome. METHODS: Retrospective analysis was conducted on pat...

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Autores principales: Han, Qing, Yang, Jianhong, Gao, Xiang, Li, Jichuan, Wu, Yuefei, Xu, Yao, Shang, Qing, Parsons, Mark W., Lin, Longting
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021998/
https://www.ncbi.nlm.nih.gov/pubmed/35463133
http://dx.doi.org/10.3389/fneur.2022.861289
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author Han, Qing
Yang, Jianhong
Gao, Xiang
Li, Jichuan
Wu, Yuefei
Xu, Yao
Shang, Qing
Parsons, Mark W.
Lin, Longting
author_facet Han, Qing
Yang, Jianhong
Gao, Xiang
Li, Jichuan
Wu, Yuefei
Xu, Yao
Shang, Qing
Parsons, Mark W.
Lin, Longting
author_sort Han, Qing
collection PubMed
description OBJECTIVE: To investigate the difference in early edema, quantified by net water uptake (NWU) based on computed tomography (CT) between ischemic core and penumbra and to explore predictors of NWU and test its predictive power for clinical outcome. METHODS: Retrospective analysis was conducted on patients admitted to Ningbo First Hospital with anterior circulation stroke and multi-modal CT. In 154 included patients, NWU of the ischemic core and penumbra were calculated and compared by Mann–Whitney U test. Correlations between NWU and variables including age, infarct time (time from symptom onset to imaging), volume of ischemic core, collateral status, and National Institutes of Health Stroke Scale (NIHSS) scores were investigated by Spearman's correlation analyses. Clinical outcome was defined using the modified Rankin Scale (mRS) at 90 days. Logistic regression and receiver operating characteristic analyses were performed to test the predictive value of NWU. Summary statistics are presented as median (interquartile range), mean (standard deviation) or estimates (95% confidence interval). RESULTS: The NWU within the ischemic core [6.1% (2.9–9.2%)] was significantly higher than that of the penumbra [1.8% (−0.8–4.0%)]. The only significant predictor of NWU within the ischemic core was infarct time (p = 0.004). The NWU within the ischemic core [odds ratio = 1.23 (1.10–1.39)], the volume of ischemic core [1.04, (1.02–1.06)], age [1.09 (1.01–1.17)], and admission NHISS score [1.05 (1.01–1.09)] were associated with the outcome of patients adjusted for sex and treatment. The predictive power for the outcome of the model was significantly higher when NWU was included (area under the curve 0.875 vs. 0.813, p < 0.05 by Delong test). CONCLUSIONS: Early edema quantified by NWU is relatively limited in the ischemic core and develops in a time-dependent manner. NWU estimates within the ischemic core may help to predict clinical outcomes of patients with acute ischemic stroke.
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spelling pubmed-90219982022-04-22 Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients Han, Qing Yang, Jianhong Gao, Xiang Li, Jichuan Wu, Yuefei Xu, Yao Shang, Qing Parsons, Mark W. Lin, Longting Front Neurol Neurology OBJECTIVE: To investigate the difference in early edema, quantified by net water uptake (NWU) based on computed tomography (CT) between ischemic core and penumbra and to explore predictors of NWU and test its predictive power for clinical outcome. METHODS: Retrospective analysis was conducted on patients admitted to Ningbo First Hospital with anterior circulation stroke and multi-modal CT. In 154 included patients, NWU of the ischemic core and penumbra were calculated and compared by Mann–Whitney U test. Correlations between NWU and variables including age, infarct time (time from symptom onset to imaging), volume of ischemic core, collateral status, and National Institutes of Health Stroke Scale (NIHSS) scores were investigated by Spearman's correlation analyses. Clinical outcome was defined using the modified Rankin Scale (mRS) at 90 days. Logistic regression and receiver operating characteristic analyses were performed to test the predictive value of NWU. Summary statistics are presented as median (interquartile range), mean (standard deviation) or estimates (95% confidence interval). RESULTS: The NWU within the ischemic core [6.1% (2.9–9.2%)] was significantly higher than that of the penumbra [1.8% (−0.8–4.0%)]. The only significant predictor of NWU within the ischemic core was infarct time (p = 0.004). The NWU within the ischemic core [odds ratio = 1.23 (1.10–1.39)], the volume of ischemic core [1.04, (1.02–1.06)], age [1.09 (1.01–1.17)], and admission NHISS score [1.05 (1.01–1.09)] were associated with the outcome of patients adjusted for sex and treatment. The predictive power for the outcome of the model was significantly higher when NWU was included (area under the curve 0.875 vs. 0.813, p < 0.05 by Delong test). CONCLUSIONS: Early edema quantified by NWU is relatively limited in the ischemic core and develops in a time-dependent manner. NWU estimates within the ischemic core may help to predict clinical outcomes of patients with acute ischemic stroke. Frontiers Media S.A. 2022-04-07 /pmc/articles/PMC9021998/ /pubmed/35463133 http://dx.doi.org/10.3389/fneur.2022.861289 Text en Copyright © 2022 Han, Yang, Gao, Li, Wu, Xu, Shang, Parsons and Lin. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Han, Qing
Yang, Jianhong
Gao, Xiang
Li, Jichuan
Wu, Yuefei
Xu, Yao
Shang, Qing
Parsons, Mark W.
Lin, Longting
Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients
title Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients
title_full Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients
title_fullStr Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients
title_full_unstemmed Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients
title_short Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients
title_sort early edema within the ischemic core is time-dependent and associated with functional outcomes of acute ischemic stroke patients
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021998/
https://www.ncbi.nlm.nih.gov/pubmed/35463133
http://dx.doi.org/10.3389/fneur.2022.861289
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