The predictive value of cerebral oxygen saturation combined with brain natriuretic peptide for hemorrhagic transformation after mechanical thrombectomy in acute ischemic stroke

WANG Peng; LIU Zhiguang; MA Zhengfei

doi:10.11958/20252420

Abstract：Objective To explore the predictive value of cerebral oxygen saturation combined with brain natriuretic peptide for hemorrhagic transformation after mechanical thrombectomy in acute ischemic stroke(AIS).Methods The clinical data of 120 AIS patients treated with mechanical thrombectomy were retrospectively analyzed.All patients underwent head CT examination within 24 to 72 hours after the operation and were divided into the non-hemorrhagic transformation group(66 cases)and the hemorrhagic transformation group(54 cases)according to whether hemorrhagic transformation occurred.The differences in general information,laboratory test results,cerebral oxygen saturation and serum brain natriuretic peptide levels were compared between the two groups of patients.The receiver operating characteristic(ROC)curve was used to evaluate the value of cerebral oxygen saturation combined with serum brain natriuretic peptide in predicting hemorrhage transformation after mechanical thrombectomy in AIS patients.Pearson correlation analysis was used to analyze the relationship between cerebral oxygen saturation and serum brain natriuretic peptide.Multivariate Logistic regression was used to analyze the effects of cerebral oxygen saturation and serum brain natriuretic peptide on hemorrhage transformation after mechanical thrombectomy in patients with AIS.Results The atrial fibrillation,the time from onset to admission,the National Institutes of Health Stroke Scale(NIHSS)score at admission and the serum brain natriuretic peptide level were all higher in the hemorrhagic transformation group than those in the non-hemorrhagic transformation group(P＜0.05),and the cerebral oxygen saturation was lower in the hemorrhagic transformation group than that in the non-hemorrhagic transformation group(P＜0.05).The cerebral oxygen saturation was negatively correlated with serum brain natriuretic peptide in AIS patients(r=-0.469,P＜0.01).The optimal cut-off points of cerebral oxygen saturation combined with serum brain natriuretic peptide level for predicting hemorrhage transformation after mechanical thrombectomy in AIS patients were 55%and 239.91 ng/L,respectively.The area under the receiver operating characteristic(ROC)curve(AUC)was 0.800(95%CI:0.718-0.868)and 0.832(95%CI:0.753-0.894),respectively.The AUC increased to 0.882 during the combined detection(95%CI:0.810-0.934).Conclusion The decreased cerebral oxygen saturation and elevated serum brain natriuretic peptide levels are significantly associated with hemorrhage transformation after mechanical thrombectomy in AIS patients.The combination of the two has a higher predictive value and can be used as a reference index for clinical evaluation.