Eosinophils, malignant brain edema, and functional outcome after mechanical thrombectomy: a mediation analysis.
4 affiliations
- 1Department of Neurology, Zhangjiagang Hospital of Traditional Chinese Medicine, Suzhou, China.
- 2Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
- 3Department of Encephalopathy, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou, China.
- 4Department of Encephalopathy, Taicang Hospital of Nanjing University of Chinese Medicine, Suzhou, China.
Abstract
Objective
To examine the independent associations of admission eosinophil count with malignant brain edema (MBE) and with poor 3-month functional outcome after mechanical thrombectomy (MT), and to quantify the statistical contribution of MBE to the eosinophil-outcome association using mediation analysis.Methods
A total of 442 consecutive AIS patients who underwent MT between May 2017 and January 2023 were analyzed. Multivariable logistic regression analysis was used to assess the association of eosinophils with MBE and poor outcome. Mediation analysis was performed to quantify the statistical contribution of MBE.Results
MBE developed in 98 (22.17%) patients. After full adjustment for confounders, each 1-standard deviation increase in standardized eosinophils was independently associated with a lower risk of MBE (OR = 0.165; 95% CI: 0.055-0.498; p = 0.00137). Consistent findings were observed when eosinophils were dichotomized by the median value (OR = 0.168; 95% CI: 0.086-0.328; p < 0.00001). Standardized eosinophils were also independently associated with reduced risk of poor outcome (OR = 0.620; 95% CI: 0.475-0.810; p = 0.00045). Mediation analysis showed a small statistical contribution of MBE to the eosinophil-outcome association: the indirect effect was -0.2109 (95% CI: -0.4016 to -0.0500; p < 0.001), and the mediated proportion was 12.05% (95% CI: 2.92-26%).Conclusion
Lower admission eosinophil levels were independently associated with higher risks of MBE and poor 3-month functional outcome. Mediation analysis indicated that MBE statistically accounted for 12.05% (95% CI: 2.92-26%) of the eosinophil-outcome association. These findings are hypothesis-generating and require external multicenter validation.
Related
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BibTeX
@article{lu2026eosinophils,
title = {{Eosinophils, malignant brain edema, and functional outcome after mechanical thrombectomy: a mediation analysis.}},
author = {Haojun Lu and Zhiliang Guo and Shuhong Yu and Jinping Yang and Guodong Xiao},
journal = {Frontiers in neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1939369},
url = {https://europepmc.org/article/MED/42908683},
note = {CC BY},
}
RIS
TY - JOUR
TI - Eosinophils, malignant brain edema, and functional outcome after mechanical thrombectomy: a mediation analysis.
AU - Haojun Lu
AU - Zhiliang Guo
AU - Shuhong Yu
AU - Jinping Yang
AU - Guodong Xiao
PY - 2026
DA - 2026/10/07
JO - Frontiers in neurology
DO - 10.3389/fneur.2026.1939369
UR - https://europepmc.org/article/MED/42908683
AB - Objective To examine the independent associations of admission eosinophil count with malignant brain edema (MBE) and with poor 3-month functional outcome after mechanical thrombectomy (MT), and to quantify the statistical contribution of MBE to the eosinophil-outcome association using mediation analysis.Methods A total of 442 consecutive AIS patients who underwent MT between May 2017 and January 2023 were analyzed. Multivariable logistic regression analysis was used to assess the association of eosinophils with MBE and poor outcome. Mediation analysis was performed to quantify the statistical contribution of MBE.Results MBE developed in 98 (22.17%) patients. After full adjustment for confounders, each 1-standard deviation increase in standardized eosinophils was independently associated with a lower risk of MBE (OR = 0.165; 95% CI: 0.055-0.498; p = 0.00137). Consistent findings were observed when eosinophils were dichotomized by the median value (OR = 0.168; 95% CI: 0.086-0.328; p < 0.00001). Standardized eosinophils were also independently associated with reduced risk of poor outcome (OR = 0.620; 95% CI: 0.475-0.810; p = 0.00045). Mediation analysis showed a small statistical contribution of MBE to the eosinophil-outcome association: the indirect effect was -0.2109 (95% CI: -0.4016 to -0.0500; p < 0.001), and the mediated proportion was 12.05% (95% CI: 2.92-26%).Conclusion Lower admission eosinophil levels were independently associated with higher risks of MBE and poor 3-month functional outcome. Mediation analysis indicated that MBE statistically accounted for 12.05% (95% CI: 2.92-26%) of the eosinophil-outcome association. These findings are hypothesis-generating and require external multicenter validation.
SN - 1664-2295
ER -