1.Predictive factors for the outcome of patients with complete recanalization after endovascular therapy for acute basilar artery occlusion
Di HU ; Zhenyu JIA ; Fang WEN ; Ting JIA ; Lizhi YU ; Linbo ZHAO ; Sheng LIU ; Chengcai XIA
International Journal of Cerebrovascular Diseases 2024;32(10):721-727
Objective:To investigate the predictive factors for the outcome of patients with complete recanalization after endovascular treatment (EVT) for acute basilar artery occlusion (ABAO).Methods:Patients with ABAO underwent EVT at Jiangsu Provincial People's Hospital and Nanjing Pukou People's Hospital from January 2015 to December 2022 were included retrospectively. Complete recanalization was defined as a modified Thrombolysis in Cerebral Infarction (mTICI) grade 3 after EVT. The main outcome measure was the clinical outcome evaluated by the modified Rankin Scale at 90 days after onset. 0-2 points were defined as good outcome and >2 points were defined as poor outcome. The secondary outcome measure was death within 90 days after onset. Multivariate logistic regression analysis was used to determine the independent predictive factors for poor outcome and mortality. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the independent predictive factors for poor outcome or mortality. Results:A total of 73 patients with completed recanalization after EVT for ABAO were enrolled, including 55 males (75.3%), aged 67.2±1.58 years, with the median baseline National Institutes of Health Stroke Scale (NIHSS) score 23, median baseline Basilar Artery on Computed Tomography Angiography (BATMAN) score 7, and median baseline posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) 8. After 90 days of onset, 34 patients (46.6%) had poor outcome and 16 (21.9%) died. Multivariate logistic regression analysis showed that higher baseline NIHSS score (odds ratio [ OR] 1.151, 95% confidence interval [ CI] 1.041-1.273; P=0.006), lower baseline pc-ASPECTS ( OR 0.096, 95% CI 0.024-0.386; P=0.001), lower baseline BATMAN score ( OR 0.394, 95% CI 0.162-0.961; P=0.041), and non-first-pass recanalization ( OR 5.011, 95% CI 1.675-23.343; P=0.016) were independently associated with the poor outcome. ROC curve analysis showed that the area under the curve for predicting poor outcome by combining these independent predictive factors was 0.966 (95% CI 0.930-0.964). Multivariate logistic regression analysis showed that older age ( OR 1.147, 95% CI 1.010-1.303; P=0.035), higher baseline NIHSS score ( OR 1.236, 95% CI 1.040-1.470; P=0.016), lower baseline pc-ASPECTS ( OR 0.011, 95% CI 0.002-0.249; P=0.015), and lower baseline BATMAN score ( OR 0.050, 95% CI 0.004-0.618; P=0.020) were independently associated with mortality within 90 days after onset. ROC curve analysis showed that the area under the curve for predicting mortality by combining these independent predictive factors was 0.948 (95% CI 0.899-0.997). Conclusion:For patients with ABAO who had complete recanalization after EVT, the baseline NIHSS score, baseline pc-ASPECTS, baseline BATMAN score, and non-first-pass recanalization are the independent predictive factors for poor outcome at 90 days after onset, while age, baseline NIHSS score, baseline pc-ASPECTS, and baseline BATMAN score are the independent predictive factors for mortality within 90 days after onset.
2.Application effects of empowerment theory combined with graphic type health education in cerebral infarction
Hong PAN ; Chengcai WEN ; Yan CHEN ; Liandong ZHAO
Chinese Journal of Modern Nursing 2015;(32):3879-3881
Objective To investigate the application of empowerment theory combined with graphic type health education in cerebral infarction patients. Methods A total of 100 cerebral infarction patients who admitted our hospital from April 2010 to June 2013, were treated as the objects of study and were averagely divided into experimental group and control group according to the random number table method. The patients of control group were treated with graphic style health education mode, while the patients in the experimental group were used empowerment theory combined with graphic type health education nursing. We compared two groups of patients′ empowerment ability, self-care ability, degree of neurological deficit, daily life ability, health knowledge awareness and the recrudescence rate of cerebral infarction in six months. Results In the experimental group, the empowerment ability, self-care ability, health knowledge awareness and daily life ability were higher than those of the control group (t=2. 268, 2. 369, 2. 245, 2. 164;P<0. 05);but the control group was higher than experimental group in neurology deficit and cerebral infarction recrudescence in 6 months ( t=2. 137,P<0. 05; χ2 =5. 383,P <0. 05). Conclusions Empowerment theory combined with graphic style health education can improve self-care ability of patients with cerebral infarction, empowerment ability, daily life ability and health knowledge awareness, and reduce neurological deficits and recrudescence rate in short term.

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