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In-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis

OBJECTIVE: We aimed to investigate whether negative diffusion weighted imaging (DWI) is related to the in-hospital clinical outcomes for ischemic stroke patients with intravenous tissues plasminogen activator (IV tPA). METHODS: We retrospectively enrolled patients who received IV tPA therapy within...

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Autores principales: Li, Guangshuo, Feng, Xueyan, Wang, Chuanying, Hao, Yahui, Wang, Shang, Xiong, Yunyun, Zhao, Xingquan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476428/
https://www.ncbi.nlm.nih.gov/pubmed/36109692
http://dx.doi.org/10.1186/s12883-022-02878-w
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author Li, Guangshuo
Feng, Xueyan
Wang, Chuanying
Hao, Yahui
Wang, Shang
Xiong, Yunyun
Zhao, Xingquan
author_facet Li, Guangshuo
Feng, Xueyan
Wang, Chuanying
Hao, Yahui
Wang, Shang
Xiong, Yunyun
Zhao, Xingquan
author_sort Li, Guangshuo
collection PubMed
description OBJECTIVE: We aimed to investigate whether negative diffusion weighted imaging (DWI) is related to the in-hospital clinical outcomes for ischemic stroke patients with intravenous tissues plasminogen activator (IV tPA). METHODS: We retrospectively enrolled patients who received IV tPA therapy within 4.5 hours from symptoms onset. The classification of DWI-positive or negative was based on post-IV tPA MR scan. Demographic factors, stroke characteristics, imaging information, and the in-hospital clinical outcomes including early neurological improvement (ENI) and favourable functional outcome were collected. Multivariable logistic regression and sensitivity analyses were conducted to test whether negative DWI imaging was an independent predictor of the in-hospital clinical outcomes. RESULTS: In the final study population, 437 patients treated with IV tPA were included and 12.36% of them had negative DWI imaging at the first MR scan post IV tPA. In the DWI-negative group, 51.9% (28/54) of the patients achieved ENI at 24 hours and 74.1% (40/54) of the patients achieved favourable clinical outcome at discharge. DWI-negative was not related to ENI (adjusted odds ratio 0.93, 95% confidence interval 0.17–4.91) or favourable clinical outcome (adjusted odds ratio 2.40, 95% confidence interval 0.48–11.95). Additional sensitivity analyses yielded similar results. CONCLUSION: DWI-negative is not associated with ENI or favourable functional outcome at discharge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-022-02878-w.
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spelling pubmed-94764282022-09-15 In-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis Li, Guangshuo Feng, Xueyan Wang, Chuanying Hao, Yahui Wang, Shang Xiong, Yunyun Zhao, Xingquan BMC Neurol Research OBJECTIVE: We aimed to investigate whether negative diffusion weighted imaging (DWI) is related to the in-hospital clinical outcomes for ischemic stroke patients with intravenous tissues plasminogen activator (IV tPA). METHODS: We retrospectively enrolled patients who received IV tPA therapy within 4.5 hours from symptoms onset. The classification of DWI-positive or negative was based on post-IV tPA MR scan. Demographic factors, stroke characteristics, imaging information, and the in-hospital clinical outcomes including early neurological improvement (ENI) and favourable functional outcome were collected. Multivariable logistic regression and sensitivity analyses were conducted to test whether negative DWI imaging was an independent predictor of the in-hospital clinical outcomes. RESULTS: In the final study population, 437 patients treated with IV tPA were included and 12.36% of them had negative DWI imaging at the first MR scan post IV tPA. In the DWI-negative group, 51.9% (28/54) of the patients achieved ENI at 24 hours and 74.1% (40/54) of the patients achieved favourable clinical outcome at discharge. DWI-negative was not related to ENI (adjusted odds ratio 0.93, 95% confidence interval 0.17–4.91) or favourable clinical outcome (adjusted odds ratio 2.40, 95% confidence interval 0.48–11.95). Additional sensitivity analyses yielded similar results. CONCLUSION: DWI-negative is not associated with ENI or favourable functional outcome at discharge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-022-02878-w. BioMed Central 2022-09-15 /pmc/articles/PMC9476428/ /pubmed/36109692 http://dx.doi.org/10.1186/s12883-022-02878-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Li, Guangshuo
Feng, Xueyan
Wang, Chuanying
Hao, Yahui
Wang, Shang
Xiong, Yunyun
Zhao, Xingquan
In-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis
title In-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis
title_full In-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis
title_fullStr In-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis
title_full_unstemmed In-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis
title_short In-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis
title_sort in-hospital clinical outcomes in diffusion weighted imaging-negative stroke treated with intravenous thrombolysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476428/
https://www.ncbi.nlm.nih.gov/pubmed/36109692
http://dx.doi.org/10.1186/s12883-022-02878-w
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