The relative cerebral blood volume (rCBV) <42% is independently associated with prolonged hospitalization in anterior circulation large vessel occlusion

Abstract

BackgroundThe pretreatment rCBV <42% lesion volume on CT Perfusion (CTP) has recently been shown to predict 90-day functional outcomes in stroke patients. However, its association with length of stay (LOS) has not yet been explored. This study aims to assess the relationship between rCBV <42% and prolonged LOS, defined as 7 days or longer.MethodsIn this retrospective evaluation of our prospectively collected database, we analyzed patients with confirmed anterior circulation large vessel occlusion on CT angiography who also received CT perfusion between 9/1/2017 and 10/01/2023. We used Student's t-test, Mann-Whitney U test, and Chi-Square test to assess differences. Logistic regression and ROC analyses were employed to evaluate the relationship between rCBV <42% and length of stay (LOS). A p-value of ≤0.05 was considered statistically significant.ResultsA total of 268 patients met our inclusion criteria. Of these, 85 (31.7%) received intravenous thrombolysis (IVT), and 221 (82.5%) underwent mechanical thrombectomy (MT). After adjusting for several variables, logistic regression analysis revealed that an rCBV <42% lesion volume was independently associated with prolonged length of stay (LOS) (aOR = 0.98, p < .001). ROC analysis indicated an area under the curve (AUC) of 0.66 (p < .001) for predicting prolonged LOS.ConclusionrCBV <42% lesion volume is independently associated with prolonged LOS. This parameter may serve as a useful adjunct tool in prognostication of AIS-LVO patients.

Keywords: Relative cerebral blood volume; infarct volume; rCBV <42%.

Figure 1.

Box and whisker plot distribution of rCBV <42% lesion volume in patients with shorter length of hospitalization of 6 days or less, and in those with prolonged hospitalization of 7 days or more. Box plot represents mean and standard deviation, whereas whiskers represent minimum and maximum values.

Figure 2.

Receiver Operating Characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.66 (95% CI: 0.60–0.72, p < .001) for predicting prolonged hospitalization.