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Decreased LF/HF ratio is associated with worse outcomes in patients who received mechanical thrombectomy under general anesthesia for emergent large vessel occlusion: a retrospective study

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Abstract

Background and purpose

We aimed to determine whether heart rate variability (HRV) was correlated to long-term outcome in patients who received mechanical thrombectomy (MT) under general anesthesia for emergent large vessel occlusion (ELVO).

Methods

Data from 106 patients receiving MT under general anesthesia to treat ELVO between January 1, 2017 and December 31, 2019 were collected in a multicenter chart review. Univariate analysis, Chi-square test, and bivariate logistic regression were performed to assess the correlations between preoperative risk factors such as HRV and long-term outcome (as indicated by the modified Rankin score [mRS] at 90 days after MT).

Results

Bivariate logistic regression revealed that decreased LF/HF (low frequency/high frequency in HRV) ratio was correlated with unfavorable functional outcome as indicated by mRS ≥ 2 (odds ratio [OR], 0.650; 95% confidence interval [CI], 0.157–0.839; p = 0.018), and functionally dependent outcome as indicated by mRS ≥ 3 (OR, 0.704; 95% CI, 0.360–0.914; p = 0.021). It was also found that ELVO in the right anterior circulation was correlated with lower LF/HF ratio, as compared with ELVO in the contralateral side (p < 0.05).

Conclusion

Our retrospective study demonstrated that worse outcome in patients with ELVO who received MT under general anesthesia induced autonomic changes and that decreased LF/HF ratio.

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Acknowledgments

Dr. Rui Li, Dr. Wen-Bo Sun, Dr. Yong-Chang Liu, and Dr. Wen-Gao Zhang in Cangzhou Central Hospital participated in editing the manuscript.

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Funding

This work was supported by Natural Science Foundation of China (No. 81701296), Programs of Science and Technology Commission Foundation of Hebei Province (No. 172777117).

Author information

Authors and Affiliations

  1. Department of Gerontology, Cangzhou Central Hospital, Cangzhou, China

    Dong-Xue Zhang

  2. Department of Neurosurgery, Cangzhou Central Hospital, Cangzhou, China

    Bao-Xu Zhang

  3. Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, China

    Xiao-Dong Wang, Yan-Chao Peng & Li-Min Zhang

  4. Department of Anesthesiology, Cangzhou People Hospital, Cangzhou, China

    Ming-Li Wang

  5. Department of Anesthesiology, Cangzhou Second People Hospital, Cangzhou, China

    Yue Fu

  6. Department of Anesthesiology, General Hospital of Huabei Petroleum Administration Bureau, Renqiu, China

    Xing-Liao Luo

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  1. Dong-Xue Zhang
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Contributions

Design of the study: Li-Min Zhang

Editing the manuscript: Dong-Xue Zhang, Li-Min Zhang

Statistical analysis: Dong-Xue Zhang, Li-Min Zhang

Data collection: Dong-Xue Zhang, Xiao-Dong Wang, Yan-Chao Peng, Ming-Li Wang, Yue Fu

All authors read and approved the final manuscript.

Corresponding author

Correspondence to Li-Min Zhang.

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The authors declare that they have no competing interests.

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This study was retrospective and approved by the Regional Ethics Committee of our three hospitals (Cangzhou Central Hospital, Cangzhou People Hospital, and Cangzhou Second People Hospital).

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Zhang, DX., Zhang, BX., Wang, XD. et al. Decreased LF/HF ratio is associated with worse outcomes in patients who received mechanical thrombectomy under general anesthesia for emergent large vessel occlusion: a retrospective study. Neurol Sci 42, 1453–1462 (2021). https://doi.org/10.1007/s10072-020-04682-1

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  • DOI: https://doi.org/10.1007/s10072-020-04682-1

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