Prolonged Venous Transit on Perfusion Imaging is Associated with Longer Lengths of Stay in Acute Large Vessel Occlusions

医学 四分位间距 冲程(发动机) 心脏病学 闭塞 优势比 内科学 外科 机械工程 工程类
作者
Manisha Koneru,Janet Mei,Dhairya A. Lakhani,Hamza Salim,Mona Shahriari,Adam A. Dmytriw,Adrien Guenego,Jeremy J. Heit,Gregory W. Albers,Dylan Wolman,Tobias D. Faizy,Benjamin Pulli,Vaibhav Vagal,Aakanksha Sriwastwa,Yasmin Aziz,Risheng Xu,Hanzhang Lu,Victor Urrutia,Elisabeth B. Marsh,Richard Leigh
出处
期刊:American Journal of Neuroradiology [American Society of Neuroradiology]
卷期号:: ajnr.A8611-ajnr.A8611 被引量:4
标识
DOI:10.3174/ajnr.a8611
摘要

ABSTRACT

BACKGROUND AND PURPOSE:

Prolonged venous transit (PVT+) is a marker of venous outflow; it is defined as the presence or absence of time-to-maximum ≥10 seconds timing in either the superior sagittal sinus or torcula. This novel perfusion imaging-based metric has been associated with higher odds of mortality and lower odds of functional recovery. This study aims to assess the relationship between PVT on admission perfusion imaging and length of hospital stay in large vessel occlusion strokes successfully reperfused with mechanical thrombectomy.

MATERIALS AND METHODS:

Acute ischemic stroke patients with large vessel occlusions in the anterior circulation successfully treated with thrombectomy between 01/2017 and 09/2022 were retrospectively reviewed. The primary outcome was length of stay in the hospital due to the acute stroke event. Univariable and forward stepwise multivariable linear regressions were performed for the primary outcome.

RESULTS:

Of 109 patients meeting inclusion, median age was 71 (interquartile range [IQR] 62-80) years. Median hospital length of stay was significantly greater in PVT+ patients (9 [IQR 6-18] days) compared to PVT-patients (6 [IQR 4-12] days, p=0.03). In multivariable regression, PVT+ was significantly associated with length of stay, and PVT+ was associated with approximately two additional days of hospital stay compared to PVT-(p=0.03).

CONCLUSIONS:

In successfully reperfused large vessel occlusion strokes, PVT+ was associated with an additional two days of hospital stay on average compared to PVT-patients, when adjusting for other clinical covariables. This simple, novel imaging metric is robust in correlating with a range of short and long term clinical outcomes. ABBREVIATIONS: VO = venous outflow; Tmax = time-to-maximum; PVT = prolonged venous transit; AIS-LVO = large vessel occlusion ischemic stroke; SSS = superior sagittal sinus; rCBF = relative cerebral blood flow; IQR = interquartile range; VIF = variance inflation factor.

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