Objective To explore the association between procalcitonin (PCT) level and the development of malignant brain edema (MBE) after acute cerebral infarction. Methods The data on patients with stroke admitted to the Department of Neurology of West China Hospital, Sichuan University between January 1, 2017 and December 31, 2018 were retrospective collected. Patients were divided into MBE group and non-MBE group based on whether MBE had occurred. The basic information and neuroimaging data of two groups of patients were compared and analyzed. Results A total of 798 patients were included. Among them, there were 93 cases of MBE (11.65%) and 705 cases of non-MBE (88.35%). The median time of MBE occurrence (lower quartile, upper quartile) was 29 (24, 54) hours after onset. The difference in the National Institutes of Health Stroke Scale, large-scale middle cerebral artery infarction, dysarthria, low fever, consciousness status, chronic heart failure, TOAST typing, mechanical ventilation, gastric tube placement, PCT on the first and third day of admission between the two groups were statistically significant (P<0.05). There was no statistically significant difference in the other indicators between the two groups (P>0.05). The results of multivariate logistic regression analysis showed that both day 1 PCT and large-scale middle cerebral artery infarction were associated with MBE. Conclusions Elevated PCT within 24 hours from onset is independently associated with the development of MBE after acute cerebral infarction. Patients with elevated PCT after cerebral infarction may require careful clinical management.
Objective To investigate the association of serum albumin and relevant composite indicators with malignant brain edema after acute ischemic stroke. Methods We screened patients with acute ischemic stroke admitted to the Department of Neurology, West China Hospital of Sichuan University between January and December 2022. The case group consisted of patients who developed malignant brain edema within 7 days of admission, while the control group consisted of patients who did not develop malignant brain edema within 7 days of admission. Multivariate logistic regression analysis was used to explore the association of serum albumin and relevant composite indicators with malignant brain edema after acute ischemic stroke. Results Finally, 428 patients were included, aged 70.00 (58.00, 82.00) years, with females accounting for 40.9% (n=175). The time from onset to admission was 10.00 (4.00, 24.00) hours. Forty-three patients (10.0%) developed malignant brain edema and were classified as the case group, and their onset time of malignant brain edema was 34.00 (22.50, 56.50) hours after the onset of the disease. Multivariate logistic regression analysis showed that the increase in the score of the baseline National Institutes of Health Stroke Scale scores [odds ratio (OR)=1.167], the combination of diabetes (OR=5.525), the treatment of thrombectomy (OR=23.875), and the neutrophil percentage-to-albumin ratio higher than the median (OR=3.806) were associated with the increased risk of malignant brain edema (P<0.05), and the successful reperfusion after thrombectomy (OR=0.120) was associated with the reduced risk of malignant brain edema (P<0.05). Conclusion A higher percentage of serum neutrophil percentage-to-albumin ratio within 24 hours of onset in patients with acute ischemic stroke is associated with an increased risk of malignant brain edema within 7 days of admission.