Systemic Inflammatory Response Syndrome and Outcomes in Ischemic Patients Treated with Endovascular Treatment

• Main Authors: Xu X, Yuan L, Wang W, Xu J, Yang Q, Zhu Y, Xu Y, Yang K, Ge L, Huang X, Zhou Z
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-12-01
• Series: Clinical Interventions in Aging
• Subjects: endovascular treatment; outcome; stroke; inflammation
• Online Access: https://www.dovepress.com/systemic-inflammatory-response-syndrome-and-outcomes-in-ischemic-patie-peer-reviewed-article-CIA

Xiangjun Xu,* Lili Yuan,* Wenbing Wang,* Junfeng Xu, Qian Yang, Yujuan Zhu, Youqing Xu, Ke Yang, Liang Ge, Xianjun Huang, Zhiming Zhou Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhiming Zhou; Xianjun HuangDepartment of Neurology, The First Affiliated Hospital of Wannan Medical College, 2# East Zheshan Road, Wuhu 241000 Anhui Province, People’s Republic of ChinaTel [phone]Fax [phone]Email [e-mail]; [e-mail]: Knowledge regarding the systemic inflammatory response syndrome (SIRS) associated with emergent large vessel occlusion (ELVO) is still insufficient. We aimed to investigate the occurrence rate, predictors, and clinical outcomes of SIRS in patients with ELVO after endovascular treatment (EVT).Patients and Methods: We retrospectively collected EVT data of patients with ELVO from July 2015 to August 2019 in our center. SIRS in the absence of infection was recorded in detail. A favorable outcome was defined as obtaining a 90-day modified Rankin Scale (mRS) score ≤ 2.Results: Among the 256 patients who received EVT, 91 (35.5%) developed SIRS. The patients who developed SIRS had a reduced favorable outcome (OR 4.112 [95% CI 1.705 to 9.920]; p=0.002) and higher mortality (OR 25.336 [95% CI 8.578 to 74.835]; p< 0.001) at 90 days. A greater SIRS burden was positively correlated with the NIHSS scores at discharge and mRS scores at 90 days (r=0.265, p=0.011; r=0.245, p=0.019). The development of SIRS was associated with neutrophilic leukocytosis, hyperglycemia, higher NIHSS scores at admission, and worse collateral circulation.Conclusion: The patients with SIRS had higher odds of poor functional outcomes and higher mortality at 90 days in the EVT-treatment setting. The severity of the inflammatory response was positively correlated with the clinical outcomes of the patients. Clinically, SIRS was associated with neutrophilic leukocytosis, hyperglycemia, baseline stroke severity, and worse collateral circulation.Keywords: endovascular treatment, outcome, stroke, inflammation