Clinical characteristics combined with inflammatory markers for predicting prognosis of patients with acute ischemic stroke after mechanical thrombectomy
10.16781/j.CN31-2187/R.20250086
- VernacularTitle:临床特征联合炎症标志物对机械取栓后急性缺血性脑卒中患者预后的预测
- Author:
Lingling ZHOU
1
;
Xuchen MENG
;
Weijie ZHONG
;
Zhaoliang SUN
;
Xiaohong SHI
;
Tanjun DENG
;
Zixian MEI
;
Jiexi XIAO
;
Dingzhong TANG
;
Yi LI
Author Information
1. 上海交通大学医学院附属第九人民医院神经外科,上海 200025
- Keywords:
ischemic stroke;
mechanical thrombectomy;
prognosis;
inflammation;
machine learning
- From:
Academic Journal of Naval Medical University
2025;46(10):1290-1296
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the potential prognostic factors of patients with acute ischemic stroke(AIS)after undergoing endovascular mechanical thrombectomy and to construct an effective predictive model.Methods A retrospective analysis of clinical data was conducted on 202 patients with anterior circulation large vessel occlusion AIS from 2 stroke centers.All patients received endovascular mechanical thrombectomy treatment,with treatment and follow-up lasting at least 90 d.Basic demographic characteristics,medical records,and baseline blood biomarker data were collected,and the potential prognostic indicators for AIS after 90 d were screened using least absolute shrinkage and selection operator(LASSO)-logistic regression analysis.Results It was found that alcohol drinking(P=0.029),hypertension(P=0.001),diabetes mellitus(P=0.021),stroke or transient ischemic attack(P=0.049),systolic blood pressure on admission(P=0.009),diastolic blood pressure on admission(P=0.038),blood glucose(P=0.003),white blood cell count(P=0.001),neutrophil count(P=0.001),fibrinogen(P=0.010),systemic immune-inflammation index(P=0.008)and neutrophil-to-lymphocyte ratio(NLR)(P＜0.001)were associated with adverse clinical outcomes.Nine significant prognostic determinants were screened through LASSO-logistic regression analysis.Multivariate logistic regression analysis revealed that male sex(P=0.008),smoking history(P=0.013),hypertension(P=0.011),lymphocyte(P=0.028),fibrinogen(P=0.016),and NLR(P＜0.001)were significant predictive factors for poor prognosis in AIS patients after endovascular thrombectomy treatment.The constructed prognostic model had an accuracy of 76.2％,a sensitivity of 78.2％,a specificity of 71.7％,and a positive predictive value of 86.7％.Conclusion The predictive model established in this study can assist clinicians in identifying high-risk patients with AIS who have undergone endovascular thrombectomy,and it provide guidance for formulating individualized treatment strategies.
