Eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in stroke

Abstract Background To investigate the effect of eosinophils on early (END) and delayed neurological deterioration (DND) after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS). Methods A total of 442 consecutive AIS patients experiencing MT between May 2017 and January 2023...

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Main Authors: Shuhong Yu, Jinping Yang, Xiaoting Han, Jijun Shi, Guodong Xiao, Zhiliang Guo
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Neuroscience
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Online Access:https://doi.org/10.1186/s12868-025-00954-8
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author Shuhong Yu
Jinping Yang
Xiaoting Han
Jijun Shi
Guodong Xiao
Zhiliang Guo
author_facet Shuhong Yu
Jinping Yang
Xiaoting Han
Jijun Shi
Guodong Xiao
Zhiliang Guo
author_sort Shuhong Yu
collection DOAJ
description Abstract Background To investigate the effect of eosinophils on early (END) and delayed neurological deterioration (DND) after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS). Methods A total of 442 consecutive AIS patients experiencing MT between May 2017 and January 2023 were analyzed. END and DND were defined as a rise of ≥ 2 points on the National Institutes of Health Stroke Scale (NIHSS) or a fall of ≥ 1 point on the Glasgow Coma Scale or death from baseline to 24 h and from 24 to 72 h, respectively. Multivariate regression analysis, generalize additive models and mediation analysis were used to assess the effect of eosinophils on END and DND and the underlying mechanisms. Results 113 (25.17%) and 47 (10.63%) patients had END and DND, respectively. Eosinophils was independently associated with END after adjusting potential confounders (odds ratio, 0.00; 95% CI, 0.00–0.80; P = 0.0441), which is consistent with the result of eosinophils (dichotomous) as a categorical variable (odds ratio, 0.40; 95% CI, 0.24–0.68; P = 0.0006). In assessing the relationship between eosinophils and DND, the inflection point was found to be 0.02, and eosinophils were independently correlated with DND at less than 0.02 (odds ratio, 0.00, 95% CI: 0.00–0.00, P = 0.0038); however, eosinophils ceased to be independently correlated with DND after exceeding 0.02 (P = 0.3519). Mediation analyses confirmed that eosinophils contribute to END in patients through symptomatic intracranial hemorrhage (indirect effect: -0.463; 95%CI: -0.902–0.19; P < 0.001). Conclusions The effects of eosinophils on END and DND are not identical.
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spelling doaj-art-17f6e2e576cb460fbd986dfc529ce4512025-08-20T02:05:46ZengBMCBMC Neuroscience1471-22022025-06-012611710.1186/s12868-025-00954-8Eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in strokeShuhong Yu0Jinping Yang1Xiaoting Han2Jijun Shi3Guodong Xiao4Zhiliang Guo5Department of Encephalopathy, Suzhou Integrated Traditional Chinese and Western Medicine HospitalDepartment of Encephalopathy, Taicang TCM Hospital, Nanjing University of Chinese MedicineDepartment of Neurology, The Nuclear Industry 417 HospitalDepartment of Neurology, The Second Affiliated Hospital of Soochow UniversityDepartment of Neurology, The Second Affiliated Hospital of Soochow UniversityDepartment of Neurology, The Second Affiliated Hospital of Soochow UniversityAbstract Background To investigate the effect of eosinophils on early (END) and delayed neurological deterioration (DND) after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS). Methods A total of 442 consecutive AIS patients experiencing MT between May 2017 and January 2023 were analyzed. END and DND were defined as a rise of ≥ 2 points on the National Institutes of Health Stroke Scale (NIHSS) or a fall of ≥ 1 point on the Glasgow Coma Scale or death from baseline to 24 h and from 24 to 72 h, respectively. Multivariate regression analysis, generalize additive models and mediation analysis were used to assess the effect of eosinophils on END and DND and the underlying mechanisms. Results 113 (25.17%) and 47 (10.63%) patients had END and DND, respectively. Eosinophils was independently associated with END after adjusting potential confounders (odds ratio, 0.00; 95% CI, 0.00–0.80; P = 0.0441), which is consistent with the result of eosinophils (dichotomous) as a categorical variable (odds ratio, 0.40; 95% CI, 0.24–0.68; P = 0.0006). In assessing the relationship between eosinophils and DND, the inflection point was found to be 0.02, and eosinophils were independently correlated with DND at less than 0.02 (odds ratio, 0.00, 95% CI: 0.00–0.00, P = 0.0038); however, eosinophils ceased to be independently correlated with DND after exceeding 0.02 (P = 0.3519). Mediation analyses confirmed that eosinophils contribute to END in patients through symptomatic intracranial hemorrhage (indirect effect: -0.463; 95%CI: -0.902–0.19; P < 0.001). Conclusions The effects of eosinophils on END and DND are not identical.https://doi.org/10.1186/s12868-025-00954-8EosinophilsIschemic strokeMechanical thrombectomyNeurological deteriorationPrediction
spellingShingle Shuhong Yu
Jinping Yang
Xiaoting Han
Jijun Shi
Guodong Xiao
Zhiliang Guo
Eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in stroke
BMC Neuroscience
Eosinophils
Ischemic stroke
Mechanical thrombectomy
Neurological deterioration
Prediction
title Eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in stroke
title_full Eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in stroke
title_fullStr Eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in stroke
title_full_unstemmed Eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in stroke
title_short Eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in stroke
title_sort eosinophils differentially affect early and delayed neurological deterioration after mechanical thrombectomy in stroke
topic Eosinophils
Ischemic stroke
Mechanical thrombectomy
Neurological deterioration
Prediction
url https://doi.org/10.1186/s12868-025-00954-8
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AT xiaotinghan eosinophilsdifferentiallyaffectearlyanddelayedneurologicaldeteriorationaftermechanicalthrombectomyinstroke
AT jijunshi eosinophilsdifferentiallyaffectearlyanddelayedneurologicaldeteriorationaftermechanicalthrombectomyinstroke
AT guodongxiao eosinophilsdifferentiallyaffectearlyanddelayedneurologicaldeteriorationaftermechanicalthrombectomyinstroke
AT zhiliangguo eosinophilsdifferentiallyaffectearlyanddelayedneurologicaldeteriorationaftermechanicalthrombectomyinstroke