J Korean Biol Nurs Sci.  2021 Aug;23(3):217-226. 10.7586/jkbns.2021.23.3.217.

Risk Factors and Clinical Outcomes of Brain Reperfusion Injury after Mechanical Thrombectomy for Ischemic Stroke

Affiliations
  • 1Department of Nursing, Asan Medical Center, Seoul, Korea
  • 2Department of Clinical Nursing, University of Ulsan, Ulsan, Korea

Abstract

Purpose
The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes.
Methods
A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher’s exact test, and logistic regression with IBM SPSS/WIN 24.0.
Results
Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome ( χ2 = 6.01, p = .014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR] = 1.14, 95% Confidence interval [CI] = 1.06-1.23), aphasia (OR = 6.16, CI = 1.62-23.40), anosognosia (OR = 4.84, CI = 1.13-20.79), presence of both aphasia and anosognosia (OR = 7.33, CI = 1.20-44.60), and time required to achieve targeted blood pressure (OR = 1.00, CI = 1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation ( χ2 = 6.32, p = .012), intensive care unit length of stay (Z = -2.08, p = .038), National Institute of Health Stroke scale score at discharge (Z = -3.14, p = .002), and modified Rankin Scale score at discharge (Z = -2.93, p = .003).
Conclusion
This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.

Keyword

Ischemic stroke; Thrombectomy; Brain; Reperfusion injury
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