Early neurological deterioration in patients with minor ischemic stroke caused by large vessel occlusion: risk factors and the impact of rescue endovascular thromboectomy on outcomes at discharge
10.3760/cma.j.issn.1673-4165.2023.05.001
- VernacularTitle:大血管闭塞所致轻型缺血性卒中患者早期神经功能恶化：危险因素和补救性血管内血栓切除术对出院时转归的影响
- Author:
Chenchen MA
1
;
Mengmeng WANG
;
Jian DING
;
Ting WU
;
Shiying SHENG
;
Hanqing LI
;
Meng LIU
Author Information
1. 苏州大学附属第三医院神经内科，常州 213004
- Keywords:
Ischemic stroke;
Severity of illness index;
Disease progression;
Endovascular procedures;
Thrombectomy;
Risk factors;
Treatment outcome
- From:
International Journal of Cerebrovascular Diseases
2023;31(5):321-326
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors of early neurological deterioration (END) in patients with minor ischemic stroke caused by large vessel occlusion (LVO) and the impact of rescue endovascular thromboectomy (REVT) on clinical outcomes of patients with END at discharge.Methods:Consecutive patients with acute minor ischemic stroke caused by LVO within 24 h of onset in the Third Affiliated Hospital, Soochow University from January 2021 to March 2023 were retrospectively enrolled. Minor ischemic stroke was defined as baseline National Institute of Health Stroke Scale (NIHSS) score ≤5 at admission. END was defined as an increase of ≥4 in the NIHSS score within 24 h after the best medical management. The modified Rankin Scale was used to evaluate the clinical outcomes of patients with END at discharge. 0-2 was defined as a good outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for END and the impact of REVT on clinical outcomes in patients with END. Results:A total of 75 patients with minor ischemic stroke caused by LVO were included, of which 31 (41.3%) developed END and 13 (41.9%) underwent REVT after END. Multivariate logistic regression analysis showed that internal carotid artery occlusion was an independent risk factor for END (odds ratio 4.304, 95% confidence interval 1.213-15.270; P=0.024), and REVT was an independent protective factor for good outcomes in patients with END (odds ratio 0.068, 95% confidence interval 0.006-0.774; P=0.030). Conclusions:The incidence of END is higher in patients with minor ischemic stroke caused by LVO, and internal carotid artery occlusion is an independent risk factor for the occurrence of END. Providing REVT after END may improve the clinical outcomes of patients with END at discharge.
