No abstract available.
Prognosis*

No abstract available.
Prognosis*

Background: Infection can be severely complicated by a dysregulated, whole-body inflammatory response known as sepsis. While previous research showed that genetic predisposition is linked to outcome differences, current patient characterization fails to determine which septic patients have greater tendencies to develop into severe sepsis or go into septic shock. As such, the identification of prognostic biomarkers may assist in identifying these high-risk patients and help improve the clinical management of the disease. Objective: In this study, we aimed to identify molecular patterns involved in sepsis. We also aimed to identify essential genes associated with the disease’s survival which could serve as potential prognosticators for the disease. Methods: We used weighted gene co-expression analysis (WGCNA) to analyze GSE63042, an RNA expression dataset from 129 patients with systemic inflammatory response syndrome or sepsis, including 78 sepsis survivors and 28 sepsis nonsurvivors. This analysis included identifying gene modules that differentiate sepsis survivors from nonsurvivors and qualitatively assessing differentially expressed genes. We then used STRING’s protein-protein interaction and gene ontology analysis to determine the functional and pathway relationships of the genes in the top modules. Lastly, we assessed the prognosticator abilities of the hub genes using ROC analysis. Results: We found four diverse co-expression gene modules significantly associated with sepsis survival. Our differential gene expression analysis, combined with protein-protein interaction and gene ontology analysis, revealed that the hub genes of these modules – TAF10, SNAPIN, PSME2, PSMB9, JUNB, and CEBPD – may serve as candidate markers for sepsis prognosis. These markers were significantly downregulated in sepsis nonsurvivors compared with sepsis survivors. Conclusion Weighted gene co-expression analysis, gene ontology enrichment analysis, and proteinprotein network interaction analysis of transcriptomic data from sepsis survivors and nonsurvivors revealed TAF10, SNAPIN, PSME2, PSMB9, JUNB, and CEBPD as potential biomarkers for sepsis prognosis. These genes are associated with functions related to proper immune response, and their downregulation in sepsis nonsurvivors suggests eventual immune exhaustion in late sepsis. Further analyses, however, are necessary to validate their roles in sepsis progression and patient survival.
prognosis

BACKGROUND: Neurologic outcomes following a cardiac arrest is reported to be detrimental and survivors face significant neurologic disability attributed to the diffuse cerebral damage from anoxia. Accurate prognostication is challenging. OBJECTIVE: To determine the prognosis of patients who had seizures after arrest. METHODS: This is an analytic, retrospective cohort study of adult patients that had successful resuscitation after cardiac arrest. The final sample size was 97. Comparison of the clinical outcomes was done using univariate and multivariate analysis. Multiple logistic regression was utilized. Level of significance was set at α-0.05. RESULTS: Post-arrest seizures increased the odds of dying up to 9 times. Age increases the odds of dying; among patients aged 65 years old and above, the odds are increased to 17 times, while among those aged 35 years old and above, the odds are up to 12 times. Presence of an intact brainstem response in the first 72 hours after arrest have 96% lower odds of dying compared to those who have none. CONCLUSION Patients with post-arrest seizures have higher morbidity and mortality rates. Patients with seizures that occur early after cardiac arrest have poorer prognosis and higher chances of death brought about by additional insults to an already damaged brain. Older patients have poorer prognosis. Preserved brainstem function seem to be a protective factor which can be a reflection of the degree of preserved brain activity despite anoxia.
Prognosis

Prognosis refers to the development of possible “outcome” of disease i.e., survival in patient with cancer. Prognostic factors are characteristics of a particular patient that can be used to predict that patient’s eventual outcome i.e., patients with advanced TNM cancer stage may have lower probability of survival than those with less advance TNM cancer stage. Thus, prognosis is a prediction of the probable outcome of a disease based on a individual’s condition and the usual course of the disease as seen in similar situations. Family physicians are often asked by patients about the probable course of their disease, they need skills on how to inform patients about this.
Prognosis

Objective To investigate the clinical features of spontaneous hypertensive intracerebral hemorrhage with different loads of cerebral small vessel disease （CSVD） and their association with prognosis.Methods A retrospective analysis was performed for the clinical data of the patients with hypertensive intracerebral hemorrhage who were hospitalized within 3 days after onset in Hebei Yanda Hospital from September 2017 to August 2021. Hematoma volume was calculated based on head CT scan results on admission； the severity of white matter hyperintensity， lacunae， enlarged perivascular spaces， and cerebral microbleeds was evaluated based on head MRI results after admission， and total CSVD score was calculated. The clinical features of spontaneous hypertensive intracerebral hemorrhage with different loads of CSVD and their association with prognosis were analyzed.Results A total of 113 patients with cerebral hemorrhage were included， among whom there were 69 male patients and 44 female patients， with a mean age of（61.89±12.47）years. The univariate linear regression analysis showed that sex and systolic blood pressure were associated with bleeding volume， while total CVSD score was not associated with bleeding volume. The univariate linear regression analysis showed that hypertension， history of intracranial hemorrhage， and total CVSD score were associated with NIHSS score on admission， and the multivariate logistic regression analysis showed that hypertension， history of intracranial hemorrhage， and total CVSD score were independent risk factors for high NIHSS score on admission. The univariate linear regression analysis showed that diabetes， smoking history， and total CVSD score were associated with MRS score on day 90 after discharge， and the multivariate logistic regression analysis showed that diabetes， smoking history， and total CVSD score were independent risk factors for poor prognosis.Conclusion The increase in total CSVD score may lead to the increases in the incidence rate of poor functional prognosis and NIHSS score on admission.
Prognosis

Objective To study the relationship between the systemic immune-inflammation （SII） index and the prognosis of intracerebral hemorrhage （ICH） in the acute phase. Methods We retrospectively collected the clinical data of patients with supratentorial ICH admitted to the Department of Neurology of Chifeng Clinical Medical College of Inner Mongolia Medical University from January 2021 to January 2022. The patients were grouped according to their outcomes （a modified Rankin Scale score of 3-6 points was considered as a poor prognosis） and SII index quartiles. The baseline data and SII index of patients with different prognoses were compared. The relationship between the SII index and the National Institutes of Health Stroke Scale （NIHSS） score and hemorrhage volume was analyzed. Results Compared with patients with a good prognosis， those with a poor prognosis had a significantly greater SII index， a significantly larger hemorrhage volume， a significantly higher proportion of intraventricular extension， and significantly higher leukocyte and neutrophil counts （all P<0.001）. Patients with the SII index ≥1.58 had a significantly higher NIHSS score and a significantly larger hemorrhage volume than patients with the SII index ≤0.53 （both P<0.001）. Conclusion The SII index is related to the acute prognosis of patients with supratentorial ICH， suggesting that regulating neuroinflammatory response may improve the prognosis of patients with ICH.
Prognosis

Objective To investigate the association between the pattern of carotid artery calcification and the prognosis of patients with acute cerebral infarction after 3 months of treatment. Methods A total of 112 patients who were diagnosed with acute ischemic stroke （AIS） in our hospital from March 2021 to September 2022 were enrolled as subjects. CT angiography was performed within 24 hours after admission， and the carotid artery was assessed in terms of calcification pattern （no calcification， intimal calcification， and medial calcification） and calcification load （low and high calcification）. After 7 days of treatment， CT reexamination was performed to evaluate hemorrhagic transformation and infarct volume. The patients were followed up for 3 months， and according to the modified Rankin Scale （mRS） score， they were divided into good prognosis group （82 patients with an mRS score of <3 points） and poor prognosis group （30 patients with an mRS score of ≥3 points）. Results Compared with the good prognosis group， the poor prognosis group had a significantly higher proportion of patients with an age of ≥70 years， a mean systolic blood pressure of ≥165 mmHg， a fasting blood glucose level of ≥7.5 mmol/L， an NIHSS score of ≥12 on admission， intimal calcification， medial calcification， high calcification， hemorrhagic transformation， and an infarct volume of ≥50 mm3 （P<0.05）. The multivariate logistic regression analysis showed that NIHSS score ≥12 on admission， intimal calcification， hemorrhagic transformation， and infarct volume ≥50 mm3 were risk factors for poor prognosis （P<0.05）. Conclusion Intimal calcification of the carotid artery may be associated with the poor short-term prognosis of AIS patients， which can be used as a new noninvasive indicator for predicting prognosis.
Prognosis

摘要 目的 探讨孤立性基底节区腔隙性脑梗死早期神经功能恶化（END）的相关影响因素。方法 连续性收集2020年1月—2023年12月就诊于郑州大学人民医院的孤立性基底节区腔隙性脑梗死患者236例，临床资料完整，根据是否出现END将患者分为END组59例及非END组177例，比较患者一般资料，使用多因素二元Logistic回归分析基底节区腔隙性脑梗死患者发生END的影响因素。结果 急性孤立性基底节区腔隙性脑梗死END发生率为25%（59/236），END组病灶累及内囊后肢患者比例、入院NIHSS评分、HbA1c水平、收缩压、女性均高于非END组，两组比较差异有统计学意义（P<0.05）。多因素二元Logistic回归模型分析显示病灶累及内囊后肢（OR=3.167，95%CI 1.305~7.690，P=0.011）是END发生的独立危险因素，HbA1c水平（OR=6.368，95%CI 1.555~26.075，P=0.010）、入院NIHSS评分（OR=2.019，95%CI 1.236~3.299，P=0.005）、收缩压（OR=1.626，95%CI 1.373~1.926，P<0.001）是END发生的相关危险因素。结论 孤立性基底节区腔隙性脑梗死END发生率较高，与病灶累及内囊后肢、入院NIHSS评分高、HbA1c水平升高、收缩压高相关。 Abstract Objective To identify influencing factors for early neurological deterioration （END） in isolated basal ganglia lacunar infarction （iBGLI）. Methods Clinical data were continuously collected from 236 patients with iBGLI confirmed by magnetic resonance imaging between January 2020 and December 2023. The patients were divided into END group （n=59） and non-ED group （n=177） according to the presence or absence of END. General patient information was compared between the two groups， and factors influencing the occurrence of END in patients with iBGLI were identified by multivariate binary logistic regression. Results The incidence of END in acute iBGLI was 25% （59/236）. The percentage of patients with lesions affecting the posterior limb of the internal capsule， admission NIHSS score， HbA1c level， systolic blood pressure， and number of females were significantly higher in the END group than in the non-END group （all P<0.05）. Multivariate binary logistic regression showed that lesions affecting the posterior limb of the internal capsule （odds ratio （OR=3.167，95%CI 1.305~7.690，P=0.011） was an independent risk factor for the development of END，whereas HbA1c level（OR=6.368，95%CI 1.555~26.075，P=0.010）， admission NIHSS score（OR=2.019，95%CI 1.236~3.299， P=0.005）， and systolic blood pressure（OR=1.626，95%CI 1.373~1.926，P<0.001） were associated risk factors for END. Conclusion The higher incidence of END in iBGLI is associated with lesions affecting the posterior limb of the internal capsule， admission NIHSS score， HbA1c level， and systolic blood pressure.
Prognosis

Objective To investigate the association between beat-to-beat blood pressure variability（BPV）and prognosis in patients with acute ischemic stroke（AIS）undergoing mechanical thrombectomy（MT）. Methods A retrospective study was conducted among 52 AIS patients who underwent MT in Stroke Center of The First Hospital of Jilin University，and beat-to-beat BPV was monitored during hospitalization. The patients were followed up to observe modified Rankin Scale（mRS）score on day 90 after disease onset，and the patients were divided into good prognosis group（mRS≤1）and poor prognosis group（mRS>1）. The two groups were compared in terms of beat-to-beat BPV during hospitalization. A multivariate logistic regression analysis was used to investigate the association between beat-to-beat BPV and prognosis. Results Compared with the good prognosis group，the poor prognosis group had significantly higher beat-to-beat successive variation（SV）and average real variability（ARV）of systolic blood pressure（SBP）[SBP-SV： 2.63（1.84，3.48）vs 3.28（2.87，4.08），P=0.032； SBP-ARV： 2.06（1.30，2.55）vs 2.59（2.23，3.53），P=0.006]. After adjustment for confounding factors such as age，sex，risk factors for stroke，and baseline NIHSS score，the multivariate logistic regression analysis showed that beat-to-beat SBP-SV（OR=2.760，95%CI 1.168-6.522，P=0.021）and SBP-ARV（OR=3.916，95%CI 1.278-12.002，P=0.017）were associated with the poor prognosis of patients. Conclusion Beat-to-beat BPV is independently associated with 90-day poor prognosis in AIS patients undergoing MT，and therefore，it can be used as a predictive factor for prognosis.
Prognosis