The Association of Whole Blood Viscosity with Clinical Outcomes After Mechanical Thrombectomy for Acute Ischemic Stroke

Öz

Background: Blood viscosity (BV) is relationship cerebrovascular events. However, the association with between BV and clinical outcomes after acute ischemic stroke (AIS) has not been studied. This study evaluated the relationship between whole blood viscosity (WBV) and clinical outcomes after AIS.
Materials and Methods: The study enrolled 240 consecutive patients with AIS who underwent mechanical thrombectomy (MT) between 2017 and 2019 years. The all patients were divided according to the modified Rankin Scale (mRS) score, as good (mRS 0–2) and poor (mRS 3–6) clinical outcomes group. WBV was calculated by the formula derived from total protein and haematocrit levels.
Results: Poor clinical outcomes group presented significantly higher WBV values both at LSR and HSR (p < 0.001). Multivariate analysis, both high WBV at LSR (Odd ratio: 2.679, p < 0.001) and high WBV at HSR (Odd ratio: 1.278, p < 0.001) were independent predictors for poor clinical outcomes. In receiver operating characteristic analysis, value of 16.1 WBV at HSR had 76.7% sensitivity and 76% specificity for predicting poor clinical outcomes and a value of 38.5 WBV at LSR had 75.3% sensitivity and 78% specificity for predicting poor clinical outcomes. There was a significant positive correlation between WBV at LSR and mRS score (0-6) (r = 0.457, p <0.001) and WBV at HSR and mRS score (0-6) (r = 0.452, p <0.001).
Conclusions: Increased WBC may be independent risk factor and correlated with poor clinical outcomes in AIS patients treated with MT.

Anahtar Kelimeler

• Blood viscosity
• Stroke
• Acute
• Thrombectomy

Akut İskemik İnme İçin Mekanik Trombektomi Sonrası Klinik Sonuçlarla Tam Kan Viskozitesinin İlişkisi

Öz

Öz. Akut İskemik İnme İçin Mekanik Trombektomi Sonrası Klinik Sonuçlarla Tam Kan Viskozitesinin İlişkisi Amaç: Artmış kan viskozitesi (KV) iskemik inme ile ilişkilidir. Ancak, akut iskemik inme (Aİİ) sonrası kan viskozitesi ve klinik sonuçlar arasındaki ilişki şu ana kadar yeterince değerlendirilmemiştir. Bu çalışmanın amacı tam kan viskozitesi (TKV) ve Aİİ sonrası klinik sonuçlar arasındaki ilişkiyi değerlendirmektir. Materyal ve metod: Çalışmaya Ocak 2017 - Aralık 2019 tarihleri arasında mekanik trombektomi (MT) yapılan 240 ardışık Aİİ hastası alındı. Hastalar 90. günde değerlendirilen modifiye Rankin Skalası (mRS) skoruna göre iyi klinik sonuç (mRS 0-2) ve kötü klinik sonuç (mRS 3–6) olarak iki gruba ayrıldı. TKV, hem düşük kayma hızında (DKH) hem de yüksek kayma hızında (YKH) hematokrit ve total plazma protein seviyeleri kullanılarak hesaplandı. Bulgular: Kötü klinik sonuç grubunda TKV hem DKH' de (34.9 ± 0.2'ye karşı 44.9 ± 3.2; p <0.001) hem de YKH'de (15.9 ± 0.28'e karşı 16.4 ± 0.42; p <0.001) anlamlı olarak daha yüksekti. ROC analizinde, YKH' deki TKV' nin 16,1’lik kesme değeri, kötü sonuçları tahmin etmek için % 76,7 duyarlılık ve % 76 özgüllüğe sahipti. DKH'deki TKV’nin 38,5’lik kesme değerikötü klinik sonuçları tahmin etmek için % 75,3 duyarlılık ve % 78 özgüllüğe sahipti. Çok değişkenli analizde, hem DKH'de hem de YKH'deki yüksek TKV değerleri, kötü sonuçlar için bağımsız prediktörler olarak saptandı. DKH'deki TKV değerleri ile mRS skoru (0-6) (r = 0.457, p <0.001) arasında, YKH’deki TKV değerleri ile mRS skoru (0-6) arasında anlamlı pozitif korelasyon vardı (r = 0.452, p <0.001). Sonuç: Hem DKH de hem de YKH de artmış TKV değerleri, MT ile tedavi edilen Aİİ hastalarında kötü klinik sonuçlar için bağımsız risk faktörü olabilir, mRS skoru ile pozitif korelasyon gösterir.

Anahtar Kelimeler

• Kan viskozitesi
• inme
• akut
• trombektomi

Kaynakça

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