Temporal Net Water Uptake Evolution and Its Association with Functional Outcome in Acute Ischemic Stroke
Abstract
Background and purpose: Subacute lesion growth after acute ischemic stroke (AIS) is associated with worse functional outcomes. The ischemic lesion severity can be assessed with net water uptake (NWU), a CT-based marker of edema. Pretreatment NWU has been associated with worse functional outcomes; however, it remains unclear how the temporal changes in NWU influence functional outcomes. In this study, we aimed to determine how associations between NWU and functional outcome vary across imaging times up to 1 week after stroke.
Materials and methods: We included patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MRCLEAN-NO IV) trial with anterior circulation large vessel occlusion who were treated with endovascular treatment and had baseline, 24-hour, and 1-week follow-up noncontrast CT scans. Functional outcome at 90 days was evaluated using the mRS, analyzed both as functional independence (mRS 0-2) and across the full ordinal distribution (mRS 0-6). In the primary analysis, associations between NWU measured at different imaging time points and functional independence were examined using univariable and multivariable logistic regression models. To evaluate temporal changes in NWU, ΔNWU was calculated at different time intervals (baseline to 24 hours, 24 hours to 1 week, and baseline to 1 week), and its association with outcomes was analyzed using analogous regression models.
Results: Of 539…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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