Bibliographic Details
| Title: |
Hyponatremia is associated with unfavorable outcomes after reperfusion treatment in acute ischemic stroke. |
| Authors: |
Pelouto, Anissa, Reimer, Jorieke, Hoorn, Ewout J., Zandbergen, Adrienne A. M., den Hertog, Heleen M. |
| Source: |
European Journal of Neurology; Mar2024, Vol. 31 Issue 3, p1-8, 8p |
| Subject Terms: |
HYPONATREMIA, ISCHEMIC stroke, STROKE patients, INTRACRANIAL hemorrhage, ENDOVASCULAR surgery, REPERFUSION |
| Geographic Terms: |
NETHERLANDS |
| Company/Entity: |
NATIONAL Institutes of Health (U.S.) |
| Abstract: |
Background and purpose: In patients with acute ischemic stroke, hyponatremia (plasma sodium < 136 mmol/L) is common and associated with unfavorable outcomes. However, data are limited for patients who underwent intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT). Therefore, our aim was to assess the impact of hyponatremia on postreperfusion outcomes. Methods: We analyzed data of consecutive patients who presented with acute ischemic stroke and were treated with IVT and/or EVT at Isala Hospital, the Netherlands, in 2019 and 2020. The primary outcome measure was the adjusted common odds ratio (acOR) for a worse modified Rankin Scale (mRS) score at 3‐month follow‐up. Secondary outcomes included symptomatic intracranial hemorrhage, in‐hospital mortality, infarct core, and penumbra volumes. Results: Of the 680 patients (median age = 73 years, 49% female, median National Institutes of Health Stroke Scale = 5), 430 patients (63%) were treated with IVT, 120 patients (18%) with EVT, and 130 patients (19%) with both. Ninety‐two patients (14%) were hyponatremic on admission. Hyponatremia was associated with a worse mRS score at 3 months (acOR = 1.76, 95% confidence interval [CI] = 1.12–2.76) and in‐hospital mortality (aOR = 2.39, 95% CI = 1.23–4.67), but not with symptomatic intracranial hemorrhage (OR = 1.17, 95% CI = 0.39–3.47). Hyponatremia was also associated with a larger core (17.2 mL, 95% CI = 2.9–31.5) and core to penumbra ratio (55.0%, 95% CI = 7.1–102.9). Conclusions: Admission hyponatremia in patients with acute ischemic stroke treated with IVT and/or EVT was independently associated with unfavorable postreperfusion outcomes, a larger infarct core, and a larger core to penumbra ratio. Future studies should address whether correction of hyponatremia improves the prognosis. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
