Correlation between inflammatory burden index and hemorrhage expansion among large-artery atherosclerosis acute ischemic stroke with hemorrhagic transformation

Hemorrhage expansion (HE) is associated with morbidity and mortality in acute ischemic stroke hemorrhagic transformation (HT) patients. To address the research gap in HE related to large-artery atherosclerosis acute ischemic stroke with hemorrhagic transformation (LAA-AIS-HT) patients, this study focused on examining the correlation between IBI and HE. We enrolled 357 LAA-AIS-HT patients and categorized into two groups depending on the presence of HE. Information on general demographics, laboratory data, and medical imaging examinations were obtained. The area under the receiver operating characteristic (ROC) curve was used to determine the predictive value. Logistic regression analysis was performed to assess comparison. A total of 357 LAA-AIS-HT patients enrolled in the study, 258 patients (72.3%) were male and the mean age (65.8 ± 11.7) years old. HE occurred in 54 patients (15.1%). After adjusting for confounders, IBI (odds ratio [OR] 1.034, 95% Confidence Interval [CI] 1.019–1.050, p < 0.001) was independently associated with HE in LAA-AIS-HT patients. When analyzing LAA subtypes individually, IBI was found to have a significantly predictive association with HE in AIS-HT patients across artery-to-artery embolization (OR 1.029, 95% CI 1.009–1.48, P = 0.003), in-situ thrombosis (OR 1.026, 95% CI 1.006–1.046, P = 0.010), hypoperfusion (OR 1.115, 95% CI 1.009–1.231, P = 0.033) and branch atheromatous disease (OR 1.051, 95% CI 1.007–1.097, P = 0.024). Among patients with LAA-AIS-HT, an increase in IBI was correlated with a greater risk of HE, with the association being prominent in the artery-to-artery embolization, in-situ thrombosis, and branch atheromatous disease subtypes of LAA.