Predictive factors of early neurological deterioration in patients with ischemic stroke
10.3760/cma.j.issn.1673-4165.2015.08.005
- VernacularTitle:缺血性卒中患者早期神经功能恶化的预测因素
- Author:
Zhongwen HU
;
Xuemin ZHAO
;
Xiaozheng YUAN
;
Rong YU
- Publication Type:Journal Article
- Keywords:
Stroke;
Brain Ischemia;
Disease Progression;
Time Factors;
Risk Factors
- From:
International Journal of Cerebrovascular Diseases
2015;(8):597-601
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for early neurological deterioration (END) in patients with ischemic stroke. Methods The consecutive patients with new acute ischemic stroke within 24 h were enrol ed. They were divided into either an END or a non-END group. Their relevant medical history, baseline clinical data, imaging examinations and laboratory test results in both groups were compared. Results A total of 95 patients with acute ischemic stroke were enrol ed, including 32 in the END group and 63 in the non-END group. There were significant differences in the proportion of patients in diabetes mel itus (χ2 =6. 081, P=0. 014), baseline National Institutes of Health Stroke Scale (NIHSS) score >15 (χ2 =9. 851, P=0. 002), baseline infarct volume >30 cm3 (χ2 =10. 815, P=0. 001), and fever (χ2 =6. 642, P=0. 010), as wel as the fasting glucose (t=2. 632, P=0. 010), homocysteine (t =2. 997, P=0. 003), C-reactive protein (t=2. 349, P=0. 021), baseline NIHSS (Z=497. 5, P=0. 001), and baseline infarct volume (Z=544. 5, P<0. 001) between the 2 groups. Furthermore, there were significant differences in the proportions of patients in large artery atherosclerotic stroke (χ2 =24. 539, P<0. 001 ) and smal arterial occlusive stroke (χ2 = 27. 913, P< 0. 001 ) in the TOAST classification, as wel as the total anterior circulation stroke (χ2 =7. 578, P<0. 006) and partial anterior circulation stroke (χ2 =4. 818, P<0. 028) in the OSCP classification. Multivariate logistic regression analysis showed that fasting glucose >6. 0 mmol/L (odds ratio [OR] 6. 951, 95%confidence interval [CI] 2. 159-22. 348; P=0. 001), homocysteine >15 μmol/L (OR 3. 301, 95% CI 1. 028-10. 595; P=0. 045), NIHSS score >15 (OR 4. 174, 95% CI 1. 772-14. 870;P=0. 028), infarct volume >30 cm3 (OR 4. 996, 95% CI 1. 334-18. 717; P=0. 017), and fever (OR 4. 528, 95% CI 1. 334-15. 372;P=0. 015) were the independent risk factors for occurring END in patients with acute ischemic stroke. Conclusions The baseline glucose, NIHSS score, infarct volume, homocysteine, and increased body temperature are the independent risk factors for occurring EDN in patients with acute ischemic stroke.