The relative cerebral blood volume (rCBV) <42% is independently associated with prolonged hospitalization in anterior circulation large vessel occlusion

Background: The pretreatment rCBV <42% lesion volume on CT Perfusion (CTP) has recently been shown to predict 90-day functional outcomes in stroke patients. However, its association with length of stay (LOS) has not yet been explored. This study aims to assess the relationship between rCBV <42% and prolonged LOS, defined as 7 days or longer. Methods: In this retrospective evaluation of our prospectively collected database, we analyzed patients with confirmed anterior circulation large vessel occlusion on CT angiography who also received CT perfusion between 9/1/2017 and 10/01/2023. We used Student’s t-test, Mann–Whitney U test, and Chi-Square test to assess differences. Logistic regression and ROC analyses were employed to evaluate the relationship between rCBV <42% and length of stay (LOS). A p-value of ≤0.05 was considered statistically significant. Results: A total of 268 patients met our inclusion criteria. Of these, 85 (31.7%) received intravenous thrombolysis (IVT), and 221 (82.5%) underwent mechanical thrombectomy (MT). After adjusting for several variables, logistic regression analysis revealed that an rCBV <42% lesion volume was independently associated with prolonged length of stay (LOS) (aOR = 0.98, p < .001). ROC analysis indicated an area under the curve (AUC) of 0.66 (p < .001) for predicting prolonged LOS. Conclusion: rCBV <42% lesion volume is independently associated with prolonged LOS. This parameter may serve as a useful adjunct tool in prognostication of AIS-LVO patients.