Influence of dehydration on collateral circulation and clinical outcome after endovascular therapy in patients with acute ischemic stroke
Por:
Guasch-Jiménez, M, Camps-Renom, P, Toscano-Prat, C, Guisado-Alonso, D, Martinez-Domeño, A, Prats-Sánchez, L, Ramos-Pachon, A, Fernández-Cadenas, I, Martínez-González, JP, Fernández-Pérez, I, Avellaneda-Gomez, C, de Celis-Ruiz, E, Rodríguez-Pardo, J, Freijo, MD, Luna, A, Moniche, F, Pardo-Galiana, B, Ortega-Quintanilla, J, Arenillas, JF, Cortijo, E, Martí-Fàbregas, J
Publicada:
1 nov 2025
Ahead of Print:
1 nov 2025
Resumen:
Introduction: Dehydration in patients with acute ischemic stroke (AIS) is associated with poor outcome. Our aim is to investigate whether dehydration is associated with collateral circulation (CC) and functional outcome in patients with AIS treated with mechanical thrombectomy (MT). Method: Prospective multicenter study of patients with anterior circulation AIS treated with MT (January 2020-June 2021). Dehydration was assessed with two formulas: plasma osmolarity and urea/creatinine (U/C) ratio. CC was quantified with an automated software (Brainomix Ltd.) on baseline computed tomography angiography. The primary outcome was the association between CC (expressed numerically as the percentage of change between hemispheres) and dehydration (osmolarity >295 mmol/L, U/C >80). Secondary outcomes included disability at discharge and at three months of follow-up, assessed using the modified Rankin scale (poor outcome: 3-6). Multivariable logistic and ordinal regression analyses were performed. Results: Two hundred sixty patients were included. 65.8% were dehydrated according to osmolarity and 2.9% according to U/C. There was no association between CC score and dehydration [71% in dehydrated vs 73% in non-dehydrated; p = 0.875]. 64.3% of dehydrated patients vs. 46.7% of non-dehydrated patients had a poor outcome at discharge (p = 0.026). In multivariable logistic regression analysis, dehydration was an independent predictor of poor outcome at discharge (OR 2.50; p = 0.011) and at three months of follow-up (OR 2.27; p = 0.046). Conclusions: Dehydration on admission is associated with poor outcome in patients with AIS treated with MT, but it is not related to CC. (c) 2024 Sociedad Espanola de Neurolog & imath;a. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
Filiaciones:
Guasch-Jiménez, M:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
Camps-Renom, P:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
Toscano-Prat, C:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
Guisado-Alonso, D:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
Martinez-Domeño, A:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
Prats-Sánchez, L:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
Ramos-Pachon, A:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
Fernández-Cadenas, I:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
Martínez-González, JP:
Hosp Santa Creu i Sant Pau, Serv Radiodiagnost, Neurol Intervencionista, Barcelona, Spain
Fernández-Pérez, I:
Hosp Del Mar, Serv Neurol, Unidad Ictus, Barcelona, Spain
Avellaneda-Gomez, C:
Hosp Del Mar, Serv Neurol, Unidad Ictus, Barcelona, Spain
de Celis-Ruiz, E:
Univ Autonoma Madrid, Serv Neurol, Madrid, Spain
Univ Autonoma Madrid, Hosp Univ La Paz, Hosp La Paz Inst Invest IdiPAZ, Ctr Ictus, Madrid, Spain
Rodríguez-Pardo, J:
Univ Autonoma Madrid, Serv Neurol, Madrid, Spain
Univ Autonoma Madrid, Hosp Univ La Paz, Hosp La Paz Inst Invest IdiPAZ, Ctr Ictus, Madrid, Spain
Freijo, MD:
Hosp Univ Cruces, Serv Neurol, Unidad Ictus, Baracaldo, Spain
Luna, A:
Hosp Univ Cruces, Serv Neurol, Unidad Ictus, Baracaldo, Spain
Moniche, F:
Hosp Univ Virgen Del Rocio, Serv Neurol, Unidad Ictus, Seville, Spain
Pardo-Galiana, B:
Hosp Univ Virgen Del Rocio, Serv Neurol, Unidad Ictus, Seville, Spain
Ortega-Quintanilla, J:
Hosp Univ Virgen Rocio, Serv Radiodiagnost, Neurol Intervencionista, Seville, Spain
Arenillas, JF:
Hosp Clin Univ Valladolid, Serv Neurol, Unidad Ictus, Valladolid, Spain
Cortijo, E:
Hosp Clin Univ Valladolid, Serv Neurol, Unidad Ictus, Valladolid, Spain
Martí-Fàbregas, J:
Univ Autonoma Barcelona, Dept Med, Inst Invest Biomedia Sant Pau IIB Sant Pau, Unidad Ictus,Serv Neurol,Hosp Santa Creu i Sant Pa, Barcelona, Spain
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