Admission blood cell counts are predictive of stroke-associated infection in acute ischemic stroke patients treated with
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ORIGINAL ARTICLE
Admission blood cell counts are predictive of stroke-associated infection in acute ischemic stroke patients treated with endovascular therapy Qi-Wen Deng 1 & Peng-Yu Gong 1 & Xiang-Liang Chen 1 & Yu-Kai Liu 1 & Teng Jiang 1 & Feng Zhou 1 & Jian-Kang Hou 1 & Min Lu 1 & Hong-Dong Zhao 1 & Yu-Qiao Zhang 1 & Wei Wang 1 & Rui Shen 1 & Shuo Li 2 & Hui-Ling Sun 3 & Ni-Hong Chen 1,4 & Hong-Chao Shi 1 Received: 14 June 2020 / Accepted: 12 October 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Stroke-associated infection (SAI) is a major medical complication in acute ischemic stroke patients (AIS) treated with endovascular therapy (EVT). Three hundred thirty-three consecutive patients with AIS caused by a large vessel occlusion in the anterior circulation who received EVT (142 (42.6%) of them were given IV tPA as bridging therapy) and 337 AIS patients who received IV tPA only (non-EVT) were enrolled in the study and evaluated to determine the association of inflammatory factors on admission with SAI. Among the 333 AIS patients undergoing EVT, SAI occurred in 219 (65.8%) patients. Patients with SAI had higher baseline National Institutes of Health Stroke Scale (NIHSS) total scores, white blood cell (WBC) and neutrophil counts, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) than those without SAI (P < 0.05). The multivariable logistic regression analyses showed that older age in addition to higher diastolic blood pressure (DBP), NIHSS score, fasting blood glucose, WBC and neutrophil counts, NLR, and PLR were significantly associated with SAI (P < 0.05). However, these associations were not revealed in 337 non-EVT AIS patients. Furthermore, based on the inflammatory markers, we developed a nomogram that provided the opportunity for more accurate predictions (compared with conventional factors) and appeared a better prognostic tool for SAI according to the decision curve analysis. In summary, if proven externally valid, our nomogram that included WBC count, NLR, and PLR may be a useful tool for SAI prediction in clinical practice. Keywords Stroke-associated infection . Acute ischemic stroke . Endovascular therapy . Inflammatory factor . Nomogram
Introduction Stroke resulting from large vessel occlusion is a major cause of mortality worldwide [1]. Recent clinical randomized
controlled trials have demonstrated that endovascular therapy (EVT) significantly improves clinical outcomes for acute ischemic stroke (AIS) with large vessel occlusion [2]. However, postinterventional complications should be considered in
Qi-Wen Deng and Peng-Yu Gong contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04827-2) contains supplementary material, which is available to authorized users. * Hui-Ling Sun [email protected]
2
Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing 210009, China
* Ni-Hong Chen [email protected]
3
General Clini
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