To analyze outcomes in AIS patients with history of cancer after Mechanical thrombectomy
Mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke (AIS) due to large vessel occlusion. The impact of MT in AIS patients with cancer is underexplored, with some research indicating higher mortality rates in cancer patients compared to those without cancer. This study aims to evaluate outcomes after MT in AIS patients with knnow history of cancer.
A retrospective cohort study was conducted using the National Inpatient Sample 2019 to identify AIS patients who underwent MT. A total of 5279 MT cases were reported during admission. Out of those, 155 MT cases were reported in patients with a primary diagnosis of cancer, and 114 MT cases were reported in patients with metastatic cancer. A binomial logistic regression was done, using smoking and age as independent variables due to their significant association with lung cancer and MT outcomes.
The study found that the overall mortality rate among AIS patients undergoing MT was 8.33% (6.80% - 10.16%). However, mortality was higher in stroke patients with cancer, reaching 12.90% (4.72% - 30.67%), and significantly higher in those with metastatic malignancy, at 26.08% (11.64% - 48.58%). The odds of mortality in AIS patients after MT were significantly lower (OR: 0.6698, 95% CI: 0.5199 - 0.8630). However, the presence of metastatic cancer was associated with a significant increase in mortality risk (OR: 2.955, 95% CI: 1.157 - 7.546, p < 0.05), which persisted even after adjusting for confounders like age, sex, and median quartile income (OR: 2.845, 95% CI: 1.107 - 7.307, p < 0.05). Patient with lung cancer was found to increased risk of mortality post-MT (OR: 5.0017, 95% CI: 1.1901 - 21.1019, p = 0.028), and the association remained significant with binomial logistic regression, accounting for smoking and age (OR: 5.43, 95% CI: 1.327 - 23.991, p = 0.019).
This study demonstrates that mortality risk is higher after MT in AIS patients with known diagnosis of cancer, particularly in those with metastatic disease. Metastatic cancer was significantly associated with higher mortality risk after MT. Additionally, patient's with lung cancer had significantly increased mortality risk after MT. These findings emphasize the importance of carefully considering the status of cancer, especially whether metastatic or not, in AIS patients undergoing MT.
