Influencing factors for endovascular therapy in patients with acute ischemic stroke aged ≥85 years
10.3760/cma.j.cn115354-20240911-00561
- VernacularTitle:≥85岁急性缺血性脑卒中患者血管内治疗的预后影响因素分析
- Author:
Xudong YAN
1
;
Hanming GE
;
Nannan HAN
;
Haojun MA
;
Yanfei WANG
;
Shilin LI
;
Tengfei LI
;
Yulun WU
;
Jiaoyun LU
;
Wenzhen SHI
;
Xiaojuan MA
;
Xiaobo ZHANG
;
Gejuan ZHANG
;
Mingze CHANG
Author Information
1. 西北大学附属医院·西安市第三医院神经内科，西安 710016
- Publication Type:Journal Article
- Keywords:
Ischemic stroke;
Large vessel occlusion;
Endovascular therapy;
Prognosis
- From:
Chinese Journal of Neuromedicine
2025;24(1):29-36
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacies of endovascular therapy (EVT) and standard medical therapy in acute ischemic stroke (AIS) patients aged ≥85 years, and analyze the independent influencing factors for poor prognosis of AIS patients after EVT.Methods:Sixty-nine AIS patients aged ≥85 years admitted to Department of Neurology, Xi'an Third Hospital from January 2018 to April 2024, including 40 accepted EVT and 28 accepted standard medicinal therapy, were enrolled. Modified Rankin scale (mRS) was used to evaluate the prognosis of the patients 90 days after onset. General data, prognosis and complications between the EVT group and standard medical therapy group were compared. General data, treatment processes and complications between patients with good prognosis and poor prognosis in the EVT group were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for poor prognosis in AIS patients after EVT.Results:Compared with the standard medical therapy, the EVT group had significantly lower NIHSS score at discharge, greater improvement in NIHSS score (NIHSS score at admission-NIHSS score at discharge), lower mRS score 90 days after onset, higher good prognosis rate, lower mortality rate within 90 days of onset, and longer hospital stay ( P<0.05). In the EVT group, 11 patients (27.5%) had good prognosis and 29 patients (72.5%) had poor prognosis 90 days after onset. Compared with the good prognosis group, the poor prognosis group had significantly higher blood glucose level and lower Alberta Stroke Program Early CT Score (ASPECT) on admission ( P<0.05). Multivariate Logistic regression analysis showed that blood glucose on admission ( OR=2.363, 95% CI: 1.134-4.928, P=0.022) and ASPECT score on admission ( OR=0.273, 95% CI: 0.088-0.854, P=0.026) were independent influencing factors for poor prognosis in AIS patients after EVT. Conclusion:AIS patients aged ≥85 years received EVT have better prognosis compared with those accepted standard medical therapy; these patients with high glucose level and low ASPECT score on admission have poor prognosis.
