Stress Hyperglycemia Could Influence Futile Recanalization in Patients Who Undergo Mechanical Thrombectomy for Stroke Caused by Large Vessel Occlusion
Bibliographic record
Abstract
BACKGROUND: Mechanical thrombectomy (MT) has become the standard treatment for acute ischemic stroke caused by large vessel occlusion (LVO). Despite successful recanalization, approximately one-half of the patients do not achieve a favorable outcome, which is known as "futile recanalization" (FR). The present study aimed to explore the association between stress hyperglycemia and FR after MT. METHODS: Data from 224 eligible patients with LVO, who underwent MT at the authors' hospital between January 2015 and December 2023, were retrospectively reviewed. Patients were divided into FR and non-FR groups according to functional independence at 3 months according to a modified Rankin scale. Factors influencing FR were identified using multivariate regression and a receiver operating characteristic (ROC) curve analysis. RESULTS: FR was observed in 40 (38.4%) of 104 patients who fulfilled the inclusion criteria. Multivariable regression analysis revealed that older age (odds ratio [OR] 1.09; 95% confidence interval [CI] 1.03-1.15; P = 0.001), an increased number of passes (OR 1.57 [95% CI 1.03-2.40]; P = 0.034), and a greater stress hyperglycemia ratio (SHR) (OR 16.0 [95% CI 1.49-172.8]; P = 0.021) were independently associated with FR after MT. ROC curve analysis revealed that a model of combining age, SHR, Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores, procedure duration, systolic blood pressure, and number of passes (area under the ROC curve: 0.83, [P < 0.01]) were accurate. CONCLUSIONS: Results of this study revealed that older age, an increased number of passes, and greater SHR were independently associated with FR after MT in patients with acute ischemic stroke caused by LVO.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".