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Baseline Characteristics Associated with Good Collateral Status Using Hypoperfusion Index as an Outcome.
Omar Hamam1, Tushar Garg1, Omar Elmandouh2
1Department of Radiology and Radiological Sciences, Division of Neuroradiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Tomography (Ann Arbor, Mich.)
|July 27, 2022
Summary
Body Mass Index (BMI) and age can help predict collateral status in patients with acute ischemic stroke (AIS) from large vessel occlusion (LVO). Lower BMI and older age are associated with poor collateral status, aiding in patient triage.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Large vessel occlusion (LVO) accounts for up to 30% of ischemic stroke cases, leading to significant patient morbidity.
- Collateral circulation in acute ischemic stroke (AIS) patients with LVO is a known predictor of clinical and radiological outcomes.
- Predicting collateral status at baseline can optimize patient triage and treatment strategies.
Purpose of the Study:
- To identify baseline patient characteristics that predict collateral status in AIS patients with anterior circulation LVO.
- To improve the triage of AIS patients with LVO by understanding factors influencing collateral circulation.
- To correlate patient demographics and clinical factors with collateral status.
Main Methods:
- Retrospective study of consecutive AIS patients with anterior circulation LVO between September 2019 and August 2021.
- Manual chart review for baseline characteristics, laboratory values, imaging features, and outcomes.
- Statistical analysis to compare patient characteristics between groups with good and poor collateral status.
Main Results:
- A significantly lower Body Mass Index (BMI) was observed in patients with poor collateral status (26.4 ± 5.6) compared to those with good collateral status (31.7 ± 12.3; p = 0.045).
- A BMI >35 kg/m2 was found to predict good collateral status.
- Patients with poor collateral status were significantly older (70.5 ± 9.6 years) than those with good collateral status (58.9 ± 15.6 years; p = 0.034).
- M1 strokes were associated with older age and BMI.
Conclusions:
- Baseline BMI and age are significant predictors of collateral status in AIS patients with anterior circulation LVO.
- Lower BMI and older age are associated with poor collateral status, suggesting potential for improved risk stratification.
- These findings can inform clinical decision-making and patient triage for LVO-induced AIS.
