Post-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators
Abstract
:1. Introduction
2. Methods
Statistical Methods
3. Results
3.1. Patient Characteristics
3.2. Impact of SAH on Patient Outcomes
3.3. Predictors of SAH Risk
3.4. Modulators of SAH’s Association with Poorer Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total Cohort | No SAH | SAH | ||
---|---|---|---|---|
Characteristic—% (n) or Mean (SD) | N = 99,219 (100%) | N = 93,045 (93.8%) | N = 6174 (6.2%) | SMD |
Female sex | 51.1% (50,657) | 50.7% (47,191) | 56.1% (3466) | 0.109 |
Age (years) | 69.1 (14.8) | 69.1 (14.8) | 69.6 (14.4) | 0.032 |
NIH Stroke Scale | 15.0 (7.8) | 15.0 (7.8) | 15.1 (7.9) | 0.018 |
Posterior circulation | 7.6% (7551) | 7.8% (7295) | 4.2% (257) | 0.185 |
Site of occlusion | ||||
Large vessel (ICA, BA, VA) | 11.7% (11,619) | 12.0% (11,119) | 8.1% (500) | 0.141 |
Middle cerebral artery (M1, M2, M3 etc.) | 85.8% (85,167) | 85.6% (79,616) | 89.9% (5552) | 0.145 |
Distal/medium vessel (ACA, PCA) | 2.5% (2433) | 2.5% (2311) | 2.0% (122) | 0.037 |
Non-embolic etiology | 62.3% (61,822) | 62.3% (57,993) | 62.0% (3829) | 0.006 |
Bleeding risk factors | ||||
Intravenous tPA use | 33.9% (33,666) | 33.9% (31,566) | 34.0% (2100) | 0.002 |
Anticoagulant use | 17.7% (17,580) | 17.8% (16,562) | 16.5% (1018) | 0.035 |
Antiplatelet use | 27.1% (26,930) | 27.2% (25,338) | 25.8% (1592) | 0.033 |
Coagulopathy | 10.4% (10,358) | 10.1% (9426) | 15.1% (932) | 0.139 |
Stroke risk factors | ||||
Atrial fibrillation or flutter | 41.3% (41,008) | 41.3% (38,468) | 41.1% (2540) | 0.004 |
Hypertension | 82.5% (81,820) | 82.6% (76,817) | 81.0% (5002) | 0.039 |
Smoking history | 18.4% (18,258) | 18.5% (17,251) | 16.3% (1006) | 0.061 |
Hyperlipidemia | 58.7% (58,284) | 58.9% (54,786) | 56.7% (3498) | 0.045 |
Diabetes | 11.9% (11,815) | 12.0% (11,151) | 10.7% (663) | 0.040 |
Diabetes (complicated) | 17.5% (17,404) | 17.5% (16,288) | 18.1% (1117) | 0.015 |
Chronic heart failure | 26.8% (26,570) | 26.7% (24,853) | 27.8% (1716) | 0.024 |
Angioplasty or stenting | 10.3% (10,180) | 10.1% (9404) | 12.6% (776) | 0.074 |
Concurrent intraparenchymal hemorrhage | 17.5% (17,366) | 17.2% (15,958) | 22.8% (1408) | 0.135 |
Predictor | Adjusted OR [95%CI] | p-Value |
---|---|---|
Higher risk | ||
DMVO * | 1.50 [1.07–2.09] | 0.017 |
Coagulopathy | 1.47 [1.33–1.62] | <0.001 |
Angioplasty | 1.44 [1.22–1.70] | <0.001 |
Concurrent intraparenchymal hemorrhage | 1.39 [1.26–1.55] | <0.001 |
MCA * | 1.28 [1.08–1.52] | 0.004 |
Female sex | 1.27 [1.17–1.37] | <0.001 |
No change in risk | ||
tPA | 1.03 [0.94–1.12] | 0.55 |
Non-embolic etiology | 1.02 [0.94–1.10] | 0.65 |
Age | 1.01 [0.98–1.05] | 0.46 |
NIHSS | 0.99 [0.93–1.05] | 0.68 |
Antiplatelet use | 0.98 [0.91–1.05] | 0.54 |
Lower risk | ||
Anticoagulant use | 0.89 [0.80–1.00] | 0.041 |
Posterior cirrculation | 0.61 [0.48–0.77] | <0.001 |
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Chen, H.; Colasurdo, M.; Khunte, M.; Malhotra, A.; Gandhi, D. Post-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators. Diagnostics 2024, 14, 1856. https://doi.org/10.3390/diagnostics14171856
Chen H, Colasurdo M, Khunte M, Malhotra A, Gandhi D. Post-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators. Diagnostics. 2024; 14(17):1856. https://doi.org/10.3390/diagnostics14171856
Chicago/Turabian StyleChen, Huanwen, Marco Colasurdo, Mihir Khunte, Ajay Malhotra, and Dheeraj Gandhi. 2024. "Post-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators" Diagnostics 14, no. 17: 1856. https://doi.org/10.3390/diagnostics14171856