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Peer-reviewedCC BY 4.0Frontiers in Neurology

Social-biological misalignment modulates the prognostic impact of infarct volume after endovascular thrombectomy

  • Yongbo Liu1,2
  • Chunguang Chen2
  • Chengbao Yang2
  1. 1The Third Clinical Medical College, Jinzhou Medical University
  2. 2Department of Neurocritical Care, Liaoyang Central Hospital
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Abstract

Objective: Endovascular thrombectomy (EVT) achieves high rates of reperfusion, yet functional recovery remains heterogeneous. We investigated whether social-biological time misalignment modifies the association between final infarct volume and 90-day functional outcome.

Methods: This retrospective cohort study included 160 patients with large vessel occlusion treated with EVT. Misalignment was quantified using a composite score incorporating occupational shift exposure and symptom onset timing. Multivariable logistic regression assessed the interaction between misalignment and final infarct volume on favorable 90-day outcome (modified Rankin Scale 0–2).

Results: Misalignment was not independently associated with favorable outcome. However, a significant interaction was observed (OR = 9.70, 95% CI 1.74–54.10, LRT p = 0.008), remaining significant after FDR correction ( q = 0.034), stable across profile likelihood and Firth penalized regression. The interaction improved model fit (AIC 124.35 → 119.38) and provided modest incremental net benefit. Exploratory threshold analysis suggested a potential inflection point approximating 25 mL, but this is hypothesis-generating and requires validation.

Conclusion: Misalignment does not exert a uniform adverse effect but acts as a state-dependent modifier, modifying the association between final infarct volume and favorable outcome. The interaction between chronobiological state and infarct burden offers a novel framework for understanding outcome heterogeneity.

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Cite

BibTeXRIS
BibTeX
@article{liu2026socialbiological,
  title = {{Social-biological misalignment modulates the prognostic impact of infarct volume after endovascular thrombectomy}},
  author = {Yongbo Liu and Chunguang Chen and Chengbao Yang},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = nov,
  doi = {10.3389/fneur.2026.1985723},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1985723/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Social-biological misalignment modulates the prognostic impact of infarct volume after endovascular thrombectomy
AU  - Yongbo Liu
AU  - Chunguang Chen
AU  - Chengbao Yang
PY  - 2026
DA  - 2026/11/03
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1985723
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1985723/full
AB  - Objective: Endovascular thrombectomy (EVT) achieves high rates of reperfusion, yet functional recovery remains heterogeneous. We investigated whether social-biological time misalignment modifies the association between final infarct volume and 90-day functional outcome.  Methods: This retrospective cohort study included 160 patients with large vessel occlusion treated with EVT. Misalignment was quantified using a composite score incorporating occupational shift exposure and symptom onset timing. Multivariable logistic regression assessed the interaction between misalignment and final infarct volume on favorable 90-day outcome (modified Rankin Scale 0–2).  Results: Misalignment was not independently associated with favorable outcome. However, a significant interaction was observed (OR = 9.70, 95% CI 1.74–54.10, LRT p = 0.008), remaining significant after FDR correction ( q = 0.034), stable across profile likelihood and Firth penalized regression. The interaction improved model fit (AIC 124.35 → 119.38) and provided modest incremental net benefit. Exploratory threshold analysis suggested a potential inflection point approximating 25 mL, but this is hypothesis-generating and requires validation.  Conclusion: Misalignment does not exert a uniform adverse effect but acts as a state-dependent modifier, modifying the association between final infarct volume and favorable outcome. The interaction between chronobiological state and infarct burden offers a novel framework for understanding outcome heterogeneity.
SN  - 1664-2295
ER  -