Risk factors for unfavorable outcomes after recanalization of large vessel occlusion in patients with acute ischemic stroke
10.3760/cma.j.cn114798-20221008-00976
- VernacularTitle:合并大血管闭塞的急性缺血性卒中患者血管再通预后不良的危险因素分析
- Author:
Jiawen YIN
1
;
Yuhui CHEN
;
Lei XU
;
Kunpeng CHEN
;
Jun LU
;
Juan CHEN
;
Jinyu QIAO
;
Tao GONG
Author Information
1. 北京医院神经内科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Stroke;
Large vessel occlusion;
Recanalization;
Risk factors
- From:
Chinese Journal of General Practitioners
2023;22(7):710-714
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze risk factors for unfavorable outcomes after recanalization of large vessel occlusion (LVO) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS-LVO who underwent recanalization treatment (including intravenous thrombolysis and endovascular intervention) at the Stroke Unit of Beijing Hospital from August 2018 to January 2022 were consecutively enrolled. According to the modified Rankin Scale (mRS) at 90-day follow-up after recanalization treatment, participants were classified as unfavorable outcomes (mRS>2) and favorable outcomes (mRS≤2). Baseline clinical data of enrolled patients was collected, and step-wise multivariate logistic regression analysis was used to identify independent risk factors for unfavorable outcomes after recanalization in AIS-LVO patients.Results:A total of 212 AIS-LVO patients were enrolled, including 86 females (41.35%), with an average age of 72.9 years. There were 75 patients in the favorable outcome group and 137 patients in the unfavorable outcome group. Compared with the favorable outcome group, the unfavorable outcome group had a higher average age, a higher proportion of females and patients with atrial fibrillation, higher baseline NIHSS, higher systolic blood pressure, and higher blood creatinine and D-dimer levels (all P<0.05). After adjusting for age and atrial fibrillation as confounding factors, multivariate logistic regression analysis showed that female ( OR=2.859, 95% CI: 1.202-6.799, P=0.018), higher baseline NIHSS ( OR=14.417, 95% CI: 6.269-33.158, P<0.001), higher pre-treatment systolic blood pressure ( OR=1.034, 95% CI: 1.015-1.054, P=0.001), higher emergency blood creatinine level ( OR=1.378, 95% CI: 1.105-1.719, P=0.005), and higher D-dimer level ( OR=3.594, 95% CI: 1.290-10.014, P=0.014) were independent risk factors for unfavorable outcomes after recanalization treatment in patients with AIS-LVO. Conclusion:Female, higher NIHSS, higher systolic blood pressure, higher blood creatinine level and D-dimer level are independent risk factors for unfavorable functional outcomes at 90 days after recanalization treatment of large vessel occlusion in patients with acute ischemic stroke.
