Association Between Endothelial Activation and Stress Index and Risk of Neurologic Deterioration and Mortality in Patients With Acute Ischemic Stroke: A Retrospective Cohort Study.
Saved in:
| Title: | Association Between Endothelial Activation and Stress Index and Risk of Neurologic Deterioration and Mortality in Patients With Acute Ischemic Stroke: A Retrospective Cohort Study. |
|---|---|
| Authors: | Yang, Xiaolan (AUTHOR), Sun, Yameng (AUTHOR), Wan, Jieqing (AUTHOR), Saleem, Suraiya (AUTHOR) |
| Source: | Acta Neurologica Scandinavica. 5/20/2026, Vol. 2026, p1-12. 12p. |
| Subjects: | Ischemic stroke, Mortality risk factors, Endothelium diseases, Cohort analysis, Clinical deterioration, Endothelial cells |
| Abstract: | Background: In‐hospital neurologic deterioration (ND) in patients with acute ischemic stroke (AIS) is associated with worse prognosis, and endothelial dysfunction may be involved in this process. This study is aimed at evaluating the association between the endothelial activation and stress index (EASIX) and the risk of ND and short‐term mortality in patients with AIS. Methods: This retrospective cohort study included patients with AIS from the Medical Information Mart for Intensive Care IV (MIMIC‐IV) database from 2008 to 2022. EASIX was calculated as (serum lactate dehydrogenase level [U/L] × creatinine level [mg/dL])/platelet count (109/L). Multivariable logistic regression and Cox regression analyses were utilized to examine the associations of log‐transformed EASIX (Ln (EASIX)) and ND and 28‐day mortality, respectively. Propensity‐score matching (PSM) and overlap weighting (OW) were performed to assess the robustness of the findings. Results: A total of 1157 AIS patients were enrolled; 305 (26.36%) died within 28 days, and 673 (58.17%) experienced ND. Patients with Ln (EASIX) ≥ 0.40 had a higher risk of ND (OR = 1.56, 95% CI: 1.17–2.07) and 28‐day mortality (HR = 1.47, 95% CI: 1.12–1.94) compared with those with Ln (EASIX) < 0.40. These associations remained significant after PSM and OW (all p < 0.05). Mediation analysis suggested that ND partially mediated the relationship between Ln (EASIX) and 28‐day mortality risk, with a mediation proportion of 89.34% (β = 0.35, 95% CI: 0.11–0.63). Conclusion: Elevated EASIX was associated with an increased risk of ND and 28‐day mortality in patients with AIS. ND may partially explain the EASIX‐mortality association, but these hypothesis‐generating findings warrant validation in future prospective studies. [ABSTRACT FROM AUTHOR] |
| Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
|
Full text is not displayed to guests.
Login for full access.
|
|
| Abstract: | Background: In‐hospital neurologic deterioration (ND) in patients with acute ischemic stroke (AIS) is associated with worse prognosis, and endothelial dysfunction may be involved in this process. This study is aimed at evaluating the association between the endothelial activation and stress index (EASIX) and the risk of ND and short‐term mortality in patients with AIS. Methods: This retrospective cohort study included patients with AIS from the Medical Information Mart for Intensive Care IV (MIMIC‐IV) database from 2008 to 2022. EASIX was calculated as (serum lactate dehydrogenase level [U/L] × creatinine level [mg/dL])/platelet count (109/L). Multivariable logistic regression and Cox regression analyses were utilized to examine the associations of log‐transformed EASIX (Ln (EASIX)) and ND and 28‐day mortality, respectively. Propensity‐score matching (PSM) and overlap weighting (OW) were performed to assess the robustness of the findings. Results: A total of 1157 AIS patients were enrolled; 305 (26.36%) died within 28 days, and 673 (58.17%) experienced ND. Patients with Ln (EASIX) ≥ 0.40 had a higher risk of ND (OR = 1.56, 95% CI: 1.17–2.07) and 28‐day mortality (HR = 1.47, 95% CI: 1.12–1.94) compared with those with Ln (EASIX) < 0.40. These associations remained significant after PSM and OW (all p < 0.05). Mediation analysis suggested that ND partially mediated the relationship between Ln (EASIX) and 28‐day mortality risk, with a mediation proportion of 89.34% (β = 0.35, 95% CI: 0.11–0.63). Conclusion: Elevated EASIX was associated with an increased risk of ND and 28‐day mortality in patients with AIS. ND may partially explain the EASIX‐mortality association, but these hypothesis‐generating findings warrant validation in future prospective studies. [ABSTRACT FROM AUTHOR] |
|---|---|
| ISSN: | 00016314 |
| DOI: | 10.1155/ane/3332330 |
