Influencing factors of early neurologic deterioration in elderly patients undergoing thrombectomy for acute occlusive stroke of large intracranial vessels
- VernacularTitle:高龄颅内大血管急性闭塞性卒中取栓患者神经功能早期恶化的影响因素分析
- Author:
Junyan XUE
1
;
Penghao ZHAO
;
Huai HUANG
;
Wenyan HAN
;
Yaning ZHANG
;
Baoshui WU
Author Information
- Keywords: acute occlusive stroke of large intracranial vessels; elderly patients; thrombecto-my; early neurological deterioration
- From: Journal of Clinical Medicine in Practice 2024;28(13):72-76,81
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the related factors of early neurological deterioration in eld-erly patients with thrombolysis for acute occlusive stroke of large intracranial vessels.Methods Clin-ical materials of 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels were retrospectively analyzed.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological function of patients within 72 hours after thrombectomy,and the pa-tients were divided into deterioration group and non-deterioration group.The baseline materials were compared between the two groups,the factors of early neurological deterioration were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of risk.Results Among 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels,92 cases(19.17％)had early neurological deterioration;the blood glucose level,white blood cell count,incidence of dysphagia,and incidence of coma in the deterioration group were sig-nificantly higher than those in the non-deterioration group(P＜0.05);the Logistic regression analy-sis showed that high level of blood glucose(95％CI,1.203 to 1.478),high level of white blood cell count(95％CI,1.159 to 1.408),dysphagia(95％CI,7.049 to 31.475),and coma(95％CI,8.375 to 43.195)were risk factors for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels(OR＞1,P＜0.05).ROC curve results showed that blood glucose,white blood cell count,dysphagia,and coma had certain predictive val-ue for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels[the area under the curve(AUC)was 0.733,0.708,0.707 and 0.701];the ROC curve showed AUC was 0.934,indicating that the model was reliable and stable.Conclusion Early neurological deterioration in elderly patients with thrombolysis for acute occlu-sive stroke of large intracranial vessels may be related to factors such as blood glucose,white blood cell count,dysphagia,and coma.Early risk assessment and relevant intervention measures can be taken clinically to improve prognosis.
