Influencing factors of poor outcome in acute ischemic stroke patients with cerebral microbleeds
10.3760/cma.j.issn.1671-8925.2018.11.004
- VernacularTitle:伴脑微出血的急性缺血性脑卒中患者预后不良的影响因素分析
- Author:
Kai WANG
1
;
Xiu'e WEI
;
Liangqun RONG
;
Zhonghai TAO
;
Lijie XIAO
Author Information
1. 徐州医科大学第二附属医院神经内科
- Keywords:
Ischemic stroke;
Cerebral microbleed;
Outcome;
Influencing factor
- From:
Chinese Journal of Neuromedicine
2018;17(11):1104-1110
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the influencing factors of poor outcome in acute ischemic stroke patients with cerebral microbleeds (CMBs). Methods In prospective study, patients with acute ischemic stroke, admitted to our hospital from October 2016 to December 2017, were divided into CMBs group and non CMBs group. The clinical data of demographics, vascular risk factors, imaging examination, laboratory examination and treatment were collected. Follow up was performed till 6 months of onset, the patients were divided into poor outcome group (modified Rankin scale [mRS] scores>2) and good outcome group (mRS scores 0-2). Univariate analysis and multivariate Logistic regression analysis were used to determine the factors of poor outcome in acute ischemic stroke patients with CMBs. Results (1) A total of 274 patients with acute ischemic stroke were enrolled in the study, including 148 patients (54.01％) of CMBs group and 126 patients (45.99％) of non CMBs group. At the 6 months of follow up, 241 patients finished follow up, and there were 131 patients (54.36％) from CMBs group, 62 patients (47.33％) with poor outcome and 69 patients (52.67％) with good outcome;there were 110 patients (45.64％) from non CMBs group, 38 patients (34.55％) with poor outcome and 72 patients (65.45％) with good outcome; the difference of poor outcome rate in the two groups was statistically significant (P<0.05). (2) Univariate analysis showed that the differences of age distribution, percentage of having history of previous stroke or transient ischemic attack, stroke onset time, TOAST etiology type, stroke severity, number of stroke lesions, treatment methods, hemorrhagic transformation, number of CMBs lesions for grading in CMBs patients from poor and good outcome subgroups had statistical significance (P<0.05). Multivariable Logistic regression analysis showed that large atherosclerotic (odds ratio [OR]=2.239, 95％ confidence interval [CI]: 1.432-2.947, P=0.044), moderate and severe stroke (OR=3.887, 95％CI: 2.403-4.643, P=0.021), severe CMBs (OR=4.491, 95％CI:2.879-6.802, P=0.017), hemorrhagic transformation (OR=2.411, 95％CI: 1.347-3.232, P=0.040) were independent risk factors for poor outcome, and intravenous thrombolysis (OR=0.676, 95％ CI:0.324-0.865, P=0.039) was independent protective factor for good outcome. Conclusions CMBs is prevalent and poor outcome is more common in acute ischemic stroke patients with CMBs. Early evaluating the number of CMBs lesions has important reference value in predicting the occurrence of poor outcome in patients with acute ischemic stroke.
