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Войти в исследования Predictors of perioperative stroke in patients with Ischemic-type moyamoya disease treated with surgical revascularization: A retrospective multicenter study.
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Musmar Basel, Roy Joanna M, Abdalrazeq Hammam, Atallah Elias, Naamani Kareem El, Chen Ching-Jen, Jabre Roland, Saad Hassan, Grossberg Jonathan A, Dmytriw Adam A, Patel Aman B, Khorasanizadeh Mirhojjat, Ogilvy Christopher S, Thomas Ajith J, Monteiro Andre, Siddiqui Adnan, Cortez Gustavo M, Hanel Ricardo A, Porto Guilherme, Spiotta Alejandro M, Piscopo Anthony J, Hasan David M, Ghorbani Mohammad, Weinberg Joshua, Nimjee Shahid M, Bekelis Kimon, Salem Mohamed M, Burkhardt Jan-Karl, Zetchi Akli, Matouk Charles, Howard Brian M, Lai Rosalind, Du Rose, Abbas Rawad, Sioutas Georgios S, Amllay Abdelaziz, Munoz Alfredo, Herial Nabeel A, Tjoumakaris Stavropoula I, Gooch Michael Reid, Rosenwasser Robert H, Jabbour Pascal
Аннотация
METHODS: We conducted a multicenter retrospective study in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. This study included patients with ischemic-type MMD who underwent surgical revascularization across 13 academic institutions in North America. Data were collected and analyzed on a per-hemisphere basis, covering patient demographics, disease characteristics, procedural details, and outcomes. Statistical analyses were performed using Stata (V.17.0), comparing baseline characteristics, and using univariable and multivariable logistic regression to identify predictors of perioperative stroke.
RESULTS: A total of 301 patients with ischemic-type MMD underwent surgical revascularization, with 34 patients (11.3 %) experiencing perioperative stroke. Patients who experienced perioperative stroke had a mean age of 43.6 years (SD 14.0) compared to 40.0 years (SD 13.9) in those without perioperative stroke (P = 0.16). Hypertension was significantly more prevalent in the perioperative stroke group (73.5 % vs. 47.9 %, P = 0.005). Current smoking was also more common in the perioperative stroke group (55.8 % vs. 38.2 %, P = 0.04). Multivariate logistic regression identified hypertension (OR 2.32, 95 % CI 1.01 to 5.37, P = 0.04) and current smoking (OR 2.28, 95 % CI 1.04 to 4.97, P = 0.03) as significant independent predictors of perioperative stroke.
CONCLUSION: Hypertension and smoking were significant predictors of perioperative stroke in patients with ischemic-type MMD undergoing surgical revascularization. These findings emphasize the importance of managing risk factors in ischemic-type MMD. Further prospective studies are needed to validate these findings.