Impact of systemic inflammatory response syndrome on acute ischemic stroke patients treated with mechanical thrombectomy.

Abstract Aim Systemic inflammatory response syndrome (SIRS) has been associated with poor outcomes after acute ischemic stroke (AIS). The primary goal of this study was to determine whether SIRS status on admission correlated with functional outcomes in AIS treated with mechanical thrombectomy (MT). Methods Consecutive patients from September 2015 to April 2019 were retrospectively reviewed for SIRS on admission. SIRS was defined as the presence of ≥2 of the following: temperature   38 °C, heart rate > 90, respiratory rate > 20, and white blood cell count  12,000 mm. Results Of 202 patients, 188 met inclusion criteria. 49 patients (26%) had evidence of SIRS. Neither basic patient demographics nor standard stroke risk factors predicted the development of SIRS. However, presentation with SIRS was correlated with higher rates of death (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.2–5.5) as well as lower rates of favorable functional outcomes at discharge (OR, 0.09; 95% CI, 0.02–0.40) and 3-month follow up (OR 0.12; 95% CI 0.03–0.43). These results remained significant even after adjustment for age, sex, baseline NIHSS, recanalization status, and prior co-morbidities. Conclusion In our sample population, SIRS was associated with worse outcomes and higher rates of mortality in AIS patients treated with MT. Recognition of key risk factors can provide better prognostication and possible future therapeutic targets.