Deans' stroke musings: Association between the serum glucose-to-potassium ratio and clinical outcomes in ischemic stroke patients after endovascular thrombectomy

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, October 11, 2024

Association between the serum glucose-to-potassium ratio and clinical outcomes in ischemic stroke patients after endovascular thrombectomy

You described a possible problem, DID NOTHING TO SOLVE IT! YOU'RE FIRED!

Association between the serum glucose-to-potassium ratio and clinical outcomes in ischemic stroke patients after endovascular thrombectomy

Qianqian Zhang¹^†

Zhihang Huang¹^†

Shuaiyu Chen¹^†

E. Yan¹

Xiaohao Zhang¹

Mouxiao Su²

Junshan Zhou¹

Wei Wang¹^*

¹Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
²Department of Neurology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China

Background and purpose: The baseline glucose-to-potassium ratio (GPR) is associated with poor outcomes in patients with acute brain injury and intracranial hemorrhage. However, the impact of serum GPR on clinical outcomes after endovascular thrombectomy (EVT) is unclear. This study aimed to evaluate the association between the GPR at admission and functional outcomes at 90 days after EVT.

Methods: We retrospectively reviewed our database for patients with acute ischemic stroke involving an anterior circulation large-vessel occlusion who received EVT between October 2019 and December 2021. The baseline serum GPR was measured after admission. The primary outcome was a 90-day poor outcome, which was defined as a modified Rankin scale score of 3–6.

Results: A total of 273 patients (mean age, 70.9 ± 11.9 years; 161 men) were finally included for analyses. During the 90-day follow-up, 151 patients (55.3%) experienced an unfavorable outcome. After adjusting for demographic characteristics and other potential confounders, the increased GPR was significantly associated with a higher risk of a 90-day poor outcome (odds ratio, 1.852; 95% confidence interval, 1.276–2.688, p = 0.001). Similar results were observed when the GPR was analyzed as a categorical variable. In addition, the restricted cubic spline observed a positive and linear association between the GPR and poor outcomes at 90 days (p = 0.329 for linearity; p = 0.001 for linearity).

Conclusion: Our study found that ischemic stroke patients with the higher GPR at admission were more likely to have an unfavorable prognosis at 3 months, suggesting that GPR may be a potential prognostic biomarker for ischemic stroke after EVT.

1 Introduction

Stroke causes 5.5 million deaths annually and is the second leading cause of death worldwide (1), contributing to a growing global socioeconomic burden. Endovascular thrombectomy (EVT) has been confirmed to be beneficial for ischemic stroke patients with large-artery occlusion (2). Currently, the time window of EVT has been extended to 24h after stroke for patients with anterior circulation large vessel occlusion (3). However, the death and disability rates are still high. Therefore, predicting the outcome of patients following EVT early and accurately is important. Currently, serum biomarkers are used to predict outcomes of ischemic stroke, including those following EVT (4). These biomarkers help guide clinical decision-making for patients undergoing EVT.

Glucose is the main source of energy to maintain cellular metabolism (5). Several studies have shown that elevated glucose levels are associated with worse clinical outcomes in patients after EVT (6). Potassium plays an important role in physiological processes (7). In large vessel occlusion stroke, the ion composition, including the potassium, has been distinctly altered (8). Due to the complex interactions between glucose and potassium in physiological processes, the serum glucose-to-potassium ratio (GPR) has been utilized in a few studies. It has been shown to serve as an early prognostic factor for acute brain injury (9), intracranial hemorrhage (10), and neuropsychiatric syndrome after carbon monoxide poisoning (11). More recently, data from a Norwegian cohort demonstrated that increased GPR was associated with higher short-term mortality in ischemic stroke patients (12). However, to the best of our knowledge, it remains unknown whether the serum GPR is related to the prognosis of ischemic stroke in those receiving EVT. We therefore performed this study to evaluate the association between GPR and functional outcome at 90 days after EVT based on a retrospective cohort.