Aim

Systemic inflammatory response syndrome (SIRS) has been associated with poor outcomes after acute ischemic stroke (AIS). The primary goal of this study was to determine whether SIRS status on admission correlated with functional outcomes in AIS treated with mechanical thrombectomy (MT).

Methods

Consecutive patients from September 2015 to April 2019 were retrospectively reviewed for SIRS on admission. SIRS was defined as the presence of ≥2 of the following: temperature < 36 °C or > 38 °C, heart rate > 90, respiratory rate > 20, and white blood cell count <4000/mm or > 12,000 mm.

Results

Of 202 patients, 188 met inclusion criteria. 49 patients (26%) had evidence of SIRS. Neither basic patient demographics nor standard stroke risk factors predicted the development of SIRS. However, presentation with SIRS was correlated with higher rates of death (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.2–5.5) as well as lower rates of favorable functional outcomes at discharge (OR, 0.09; 95% CI, 0.02–0.40) and 3-month follow up (OR 0.12; 95% CI 0.03–0.43). These results remained significant even after adjustment for age, sex, baseline NIHSS, recanalization status, and prior co-morbidities.

Conclusion

In our sample population, SIRS was associated with worse outcomes and higher rates of mortality in AIS patients treated with MT. Recognition of key risk factors can provide better prognostication and possible future therapeutic targets.

中文翻译：

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全身炎症反应综合征对机械取栓治疗急性缺血性脑卒中患者的影响

目的

全身炎症反应综合征 (SIRS) 与急性缺血性卒中 (AIS) 后的不良预后有关。本研究的主要目标是确定入院时的 SIRS 状态是否与机械取栓 (MT) 治疗的 AIS 的功能结果相关。

方法

对 2015 年 9 月至 2019 年 4 月的连续患者在入院时进行 SIRS 回顾性评估。SIRS 被定义为存在以下≥2 项：体温 < 36 °C 或 > 38 °C，心率 > 90，呼吸频率 > 20，和白细胞计数 <4000/mm 或 > 12,000 mm。

结果

在 202 名患者中，188 名符合纳入标准。49 名患者 (26%) 有 SIRS 的证据。基本的患者人口统计资料和标准的卒中危险因素都不能预测 SIRS 的发展。然而，SIRS 的表现与较高的死亡率相关（比值比 [OR]，2.6；95% 置信区间 [CI]，1.2-5.5）以及出院时良好的功能结果发生率较低（OR，0.09；95 % CI，0.02–0.40）和 3 个月随访（OR 0.12；95% CI 0.03–0.43）。即使在调整了年龄、性别、基线 NIHSS、再通状态和既往合并症后，这些结果仍然显着。

结论

在我们的样本人群中，SIRS 与接受 MT 治疗的 AIS 患者的较差结果和较高死亡率相关。识别关键风险因素可以提供更好的预后和可能的未来治疗目标。