Liver fibrosis indices predict malignant cerebral edema after endovascular therapy for anterior circulation large vessel occlusion stroke: a retrospective cohort study

Liver fibrosis indices predict malignant cerebral edema after endovascular therapy for anterior circulation large vessel occlusion stroke: a retrospective cohort study

ObjectiveTo investigate the association between liver fibrosis indices and malignant cerebral edema (MCE) following endovascular therapy (EVT) for anterior circulation large vessel occlusion (LVO) stroke.MethodsThis single-center, retrospective cohort study consecutively enrolled 340 anterior circul...

Full description

Saved in:
Bibliographic Details
Main Authors: Weiwei Gao, Yanan Zhao, Jingjing She, Ziwei Wu, Lijuan Cai, Jianzhong Lin, Xingyu Chen, Renjing Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
Subjects:
large vessel occlusion
malignant cerebral edema
endovascular therapy
liver fibrosis indices
anterior circulation
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1569698/full
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ObjectiveTo investigate the association between liver fibrosis indices and malignant cerebral edema (MCE) following endovascular therapy (EVT) for anterior circulation large vessel occlusion (LVO) stroke.MethodsThis single-center, retrospective cohort study consecutively enrolled 340 anterior circulation LVO stroke patients who underwent EVT between January 2018 and December 2024. The primary outcome was MCE, defined as a midline shift >5 mm at the level of the septum pellucidum or pineal gland, accompanied by the disappearance of the perimesencephalic cistern or the need for decompressive craniectomy. Multivariable logistic regression models were used to assess the independent associations of eight liver fibrosis indices with MCE, and restricted cubic spline regression analysis (RCS) was employed to explore their nonlinear relationships. The predictive performance was evaluated using receiver operating characteristic curves.ResultsMCE occurred in 69 patients (20.3%). After adjusting for multiple confounders, elevated fibrosis-4 index (FIB-4) (OR = 1.41, 95% CI: 1.09–1.82), modified FIB-4 (OR = 1.14, 95% CI: 1.05–1.23), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (ARR) (OR = 2.35, 95% CI: 1.57–3.52), and AST/ALT-platelet ratio index (AARPRI) (OR = 2.63, 95% CI: 1.69–4.10) were independently associated with an increased risk of MCE, while FIB-5 index showed a negative association (OR = 0.89, 95% CI: 0.83–0.94). These liver fibrosis indices demonstrated moderate predictive performance (AUC: 0.65–0.68). RCS analysis revealed that most liver fibrosis indices exhibited an overall increasing dose–response relationship with MCE risk (both P-overall<0.05).ConclusionNon-invasive liver fibrosis indices could serve as novel biomarkers for risk stratification of MCE following EVT for stroke. These readily available tools may help identify high-risk patients who might benefit from early preventive interventions.
ISSN:1664-2295

Similar Items