Impact of thrombocytopenia on hemorrhagic complications after endovascular therapy for acute large vessel occlusion : Sub-analysis of RESCUE-Japan registry 2
Copyright © 2023 Elsevier B.V. All rights reserved..
BACKGROUND: Endovascular treatment (EVT) for patients with large vessel occlusion (LVO) and concurrent thrombocytopenia raises concerns about hemorrhagic complications. We examined the association between thrombocytopenia and clinical outcomes after EVT.
METHODS: This is a sub-analysis of the RESCUE-Japan Registry 2, a nationwide registry that enrolled 2420 consecutive acute LVO patients. We evaluated the clinical outcomes in patients who underwent EVT according to their platelet count on admission (Moderate/Severe, < 100 × 109 /L; Mild, 100 to ≤150 × 109/L; Normal, ≥ 150 × 109/L). The outcomes included any and symptomatic intracranial hemorrhage (ICH) after EVT, and modified Rankin Scale (mRS) at 90 days.
RESULTS: Of 1268 patients who underwent EVT, the Moderate/Severe and Mild groups consisted of 41 (3.2%), and 193 (15.2%) patients. Any ICH occurred in 37%, 35%, and 24% of Moderate/Severe, Mild, and Normal group patients, respectively, and the adjusted ORs (95% CIs) were 1.50 (0.71-3.18) for Moderate/Severe and 1.87 (1.28-2.73) for Mild, compared to the Normal group (p for trend = 0.004). Symptomatic ICH increased with the severity of thrombocytopenia (9.8% vs 3.6% vs 2.1%), and adjusted ORs were 4.43 (1.16-17.0) in Moderate/Severe and 1.85 (0.71-4.86) in Mild (p for trend = 0.10). Mortality was significantly associated with the severity of thrombocytopenia (p for trend = 0.005), and adjusted ORs were 3.26 (1.29-8.26) in the Moderate/Severe and 2.76 (1.58-4.84) in the Mild groups.
CONCLUSIONS: Thrombocytopenia in LVO patients was not rare and associated with the incidence and manifestation of ICH after EVT.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:449 |
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| Enthalten in: |
Journal of the neurological sciences - 449(2023) vom: 15. Juni, Seite 120659 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fujiwara, Satoru [VerfasserIn] |
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| Links: |
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| Themen: |
Endovascular treatment |
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| Anmerkungen: |
Date Completed 16.05.2023 Date Revised 16.05.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jns.2023.120659 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM355837625 |
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| 041 | |a eng | ||
| 100 | 1 | |a Fujiwara, Satoru |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of thrombocytopenia on hemorrhagic complications after endovascular therapy for acute large vessel occlusion |b Sub-analysis of RESCUE-Japan registry 2 |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 16.05.2023 | ||
| 500 | |a Date Revised 16.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Endovascular treatment (EVT) for patients with large vessel occlusion (LVO) and concurrent thrombocytopenia raises concerns about hemorrhagic complications. We examined the association between thrombocytopenia and clinical outcomes after EVT | ||
| 520 | |a METHODS: This is a sub-analysis of the RESCUE-Japan Registry 2, a nationwide registry that enrolled 2420 consecutive acute LVO patients. We evaluated the clinical outcomes in patients who underwent EVT according to their platelet count on admission (Moderate/Severe, < 100 × 109 /L; Mild, 100 to ≤150 × 109/L; Normal, ≥ 150 × 109/L). The outcomes included any and symptomatic intracranial hemorrhage (ICH) after EVT, and modified Rankin Scale (mRS) at 90 days | ||
| 520 | |a RESULTS: Of 1268 patients who underwent EVT, the Moderate/Severe and Mild groups consisted of 41 (3.2%), and 193 (15.2%) patients. Any ICH occurred in 37%, 35%, and 24% of Moderate/Severe, Mild, and Normal group patients, respectively, and the adjusted ORs (95% CIs) were 1.50 (0.71-3.18) for Moderate/Severe and 1.87 (1.28-2.73) for Mild, compared to the Normal group (p for trend = 0.004). Symptomatic ICH increased with the severity of thrombocytopenia (9.8% vs 3.6% vs 2.1%), and adjusted ORs were 4.43 (1.16-17.0) in Moderate/Severe and 1.85 (0.71-4.86) in Mild (p for trend = 0.10). Mortality was significantly associated with the severity of thrombocytopenia (p for trend = 0.005), and adjusted ORs were 3.26 (1.29-8.26) in the Moderate/Severe and 2.76 (1.58-4.84) in the Mild groups | ||
| 520 | |a CONCLUSIONS: Thrombocytopenia in LVO patients was not rare and associated with the incidence and manifestation of ICH after EVT | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Endovascular treatment | |
| 650 | 4 | |a Intracranial hemorrhage | |
| 650 | 4 | |a Large vessel occlusion | |
| 650 | 4 | |a Platelet counts | |
| 650 | 4 | |a Thrombocytopenia | |
| 700 | 1 | |a Sakai, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Imamura, Hirotoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Ohara, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Tanaka, Kanta |e verfasserin |4 aut | |
| 700 | 1 | |a Yamagami, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Matsumoto, Yasushi |e verfasserin |4 aut | |
| 700 | 1 | |a Takeuchi, Masataka |e verfasserin |4 aut | |
| 700 | 1 | |a Uchida, Kazutaka |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshimura, Shinichi |e verfasserin |4 aut | |
| 700 | 1 | |a Morimoto, Takeshi |e verfasserin |4 aut | |
| 700 | 0 | |a RESCUE-Japan Registry 2 Investigators |e verfasserin |4 aut | |
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