Outcomes and risk factors for infection after endovascular treatment in patients with acute ischemic stroke

Abstract

AbstractAimsInfection is a common complication following acute ischemic stroke (AIS) and significantly contributes to poor functional outcomes after stroke. This study aimed to investigate the effects of infection after endovascular treatment (post‐EVT infection) on clinical outcomes and risk factors in patients with AIS.MethodsWe retrospectively analyzed AIS patients treated with endovascular treatment (EVT) between January 2016 and December 2022. A post‐EVT infection was defined as any infection diagnosed within 7 days after EVT. The primary outcome was functional independence, defined as a modified Rankin scale (mRS) score of 0–2 at 90 days. A multivariable logistic regression analysis was conducted to determine independent predictors of post‐EVT infection and the associations between post‐EVT infection and clinical outcomes.ResultsA total of 675 patients were included in the analysis; 306 (45.3%) of them had post‐EVT infections. Patients with post‐EVT infection had a lower rate of functional independence than patients without infection (31% vs 65%, p = 0.006). In addition, patients with post‐EVT infection achieved less early neurological improvement (ENI) after EVT (25.8% vs 47.4%, p < 0.001). For safety outcomes, the infection group had a higher incidence of any intracranial hemorrhage (23.9% vs 15.7%, p = 0.01) and symptomatic intracranial hemorrhage (10.1% vs 5.1%, p = 0.01). Unsuccessful recanalization (aOR 1.87, 95% CI 1.11–3.13; p = 0.02) and general anesthesia (aOR 2.22, 95% CI 1.25–3.95; p = 0.01) were identified as independent predictors for post‐EVT infection in logistic regression analysis.ConclusionAIS patients who develop post‐EVT infections are more likely to experience poor clinical outcomes. Unsuccessful recanalization and general anesthesia were independent risk factors for the development of post‐EVT infection.