Effect of Statins on Infections in Patients Who Experienced an Acute Ischemic Stroke: Intelligent Data Acquisition of Computed Tomography Image Information (Preprint)
Authors: Yang Weiye , Yang Jian , Xiong Xin , Weng Xu , Wu Wenjing 
Published: March 2020

BACKGROUND

Stroke is one of the main causes of chronic disability and death, and the most common complication of stroke is infection development, which is the main influencing factor of the 30-day mortality. Statins have shown to reduce the incidence and mortality of cardiovascular and cerebrovascular events and the expression of inflammatory factors. However, the effect of statin administration on the prognosis of patients who have had acute ischemic stroke complicated with infection has not been determined.

OBJECTIVE

The aim of this study was to investigate the effect of statins in patients who developed an infection after an acute ischemic stroke by intelligent data acquisition of computed tomography (CT) image information.

METHODS

In this study, the subjects were 122 patients who developed infections after experiencing an acute ischemic stroke and admitted in our hospital from June 2016 to December 2018. They were divided into the test group (statin treatment, n=69) and control group (no statin treatment, n=53). On admission, the differences in the baseline data, stroke classification, neurological impairment, and the number of affected cerebral lobes between the 2 groups were compared. The probability of infections of the pulmonary system, urinary system, or coinfection in patients with different stroke types was also compared. Moreover, the modified Rankin score and Barthel index were used to evaluate the prognosis of the patients. Filtered back projection (FBP) and iDose4 algorithms were used to reconstruct the CT images of these patients, and the differences in the noise and signal-to-noise ratio of the reconstructed images by different algorithms were compared. CT images were used to analyze the affected cerebral lobes of the patients qualitatively and quantitatively.

RESULTS

The proportion of the total anterior circulation infarcts (TACIs) in the control group was significantly higher than that of the TACIs in the test group (P<.001). The incidence of pulmonary infection in patients with TACIs in the control group was significantly higher than that in the test group (P<.001). After treatment, the Rankin scores of the test group were significantly lower than those of the control group (P=.02), while the Barthel index of the test group was significantly higher than that of the control group (P=.02). The noise in the image reconstructed by the iDose4 method was significantly lower than that constructed by the FBP method (P<.001). The control group and the test group showed statistically significant differences in the proportion of involvement in the right parietal lobe (P=.04), left insula (P=.04), left internal capsule (P=.01), subcortex (P=.05), and right brain stem (P=.08).

CONCLUSIONS

The iDose algorithm can effectively reconstruct CT images of patients who have had a stroke, and statins can significantly improve the left internal capsule and the subcutaneous involvement in these patients, thereby effectively improving the prognosis of patients with acute stroke.

CLINICALTRIAL

CRD42017079863