Brain imaging determinants of functional prognosis after severe endocarditis: a multicenter observational study

Autor: Yves-Olivier, Guettard, Alexandre, Gros, Hikaru, Fukutomi, Xavier, Pillois, Sebastien, Préau, Yoan, Lavie-Badie, Delphine, Marest, Raphaël P, Martins, Elisabeth, Coupez, Rémi, Coudroy, Benjamin, Seguy, Alexandre, Boyer, Thomas, Tourdias, Stein, Silva
Přispěvatelé: CHU Bordeaux [Bordeaux], Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale (U1215 Inserm - UB), Université de Bordeaux (UB)-Institut François Magendie-Institut National de la Santé et de la Recherche Médicale (INSERM), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], CHU Lille, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre hospitalier universitaire de Nantes (CHU Nantes), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], CHU Clermont-Ferrand, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent
Rok vydání: 2021
Předmět:
Zdroj: Neurological Sciences
Neurological Sciences, 2022, 43 (6), pp.3759-3768. ⟨10.1007/s10072-021-05789-9⟩
ISSN: 1590-3478
1590-1874
DOI: 10.1007/s10072-021-05789-9⟩
Popis: International audience; Objective We developed a detailed imaging phenotype of the cerebral complications in critically ill patients with infective endocarditis (IE) and determine whether any specific imaging pattern could impact prognostic information. Methods One hundred ninety-two patients admitted to the intensive care units of seven tertiary centers with severe, definite left IE and neurological complications were included. All underwent cerebral imaging few days after admission to define the types of lesions, their volumes, and their locations using voxel-based lesion-symptom mapping (VLSM). We employed uni- and multi-variate logistic regression analyses to explore the associations among imaging features and other prognostic variables and the 6-month modified Rankin Scale (mRS) score. Results Ischemic lesions were the most common lesions (75%; mean volume, 15.3 +/- 33 mL) followed by microbleeds (50%; mean number, 4 +/- 7.5), subarachnoidal hemorrhages (20%), hemorrhagic strokes (16%; mean volume, 14.6 +/- 21 mL), and hemorrhagic transformations (10%; mean volume, 5.6 +/- 11 mL). The volume of hemorrhagic transformations, the severity of leukopathy, and the compromises of certain locations on the motor pathway from the VLSM were associated with a poor 6-month mRS score on univariate analyses. However, upon multivariate analyses, no such specific imaging pattern independently predicted the mRS; this was instead influenced principally by age (OR = 1.03 [1.004-1.06]) and cardiac surgery status (OR = 0.06 [0.02-0.16]) in the entire cohort, and by age (OR= 1.04 [1.01-1.08]) and Staphylococcus aureus status (OR= 2.86 [1.19-6.89]) in operated patients. Conclusions In a cohort of severely ill IE patients with neurological complications, no specific imaging pattern could be highlighted as a reliable predictor of prognosis.
Databáze: OpenAIRE
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