Risk factor of the growth rate of cerebral infarction and its effects on the prognosis in elderly patients with acute ischemic stroke
10.3760/cma.j.issn.0254-9026.2022.04.011
- VernacularTitle:老年急性缺血性卒中患者脑梗死增长速率的影响因素及对预后的影响
- Author:
Ling LI
1
;
Rui WANG
;
Hong WANG
;
Ruoyao CAO
;
Yao LU
;
Zilong YOU
;
Ximeng YANG
;
Jing HE
;
Juan CHEN
Author Information
1. 北京医院 国家老年医学中心 国家卫生健康委北京老年医学研究所 国家卫生健康委老年医学重点实验室 中国医学科学院老年医学研究所，北京 100730
- Keywords:
Stroke;
Brain infarction;
Prognosis;
Collateral circulation
- From:
Chinese Journal of Geriatrics
2022;41(4):417-422
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors of infarct growth rate of elderly acute ischemic stroke(AIS)patients with endovascular treatment(EVT)and its influence on prognosis.Methods:Elderly AIS patients who underwent EVT at Beijing hospital from June 2016 to October 2020 were retrospectively included.Infarct growth rate(ml/h)=infarct core volume(ml)/time from stroke onset to CTP examination(h).Based on the rate of infarct growth and the patient's clinical severity, ROC curve was established, and the cut-off value of the ROC curve was obtained.By the cut-off value of the rate of infarct growth, the patients were divided into cerebral infarct slow-growth group and rapid-growth group.Predictors of rapid growth in infarct were analyzed by univariate and multivariate analysis.The patients were divided into good prognosis group(mRS score 0-2)and poor prognosis group(mRS score 3-6)according to the mRS score at the day 90 and the predictors of poor prognosis were analyzed separately.Results:A total of 67 elderly AIS patients were included with age ranging from 65-96 years and an average of(78.8±7.6)years.(1)The cut-off value of the optimal infarct growth rate for patients with good and poor prognosis was 8.89 ml/h.The patients were divided into fast-growth group(26 patients)and slow-growth group(41 patients)according the cut-off value.(2)Multivariate logistic regression showed that only poor collateral circulation was an independent predictor for fast infarct growth( OR=0.162, 95% CI: 0.053-0.489).(3)Faster infarct growth rate( OR=1.173, 95% CI: 1.044-1.318)and high NIHSS score( OR=1.146, 95% CI: 1.018-1.291)were predictors of poor prognosis. Conclusions:Collateral circulation status is a major influencing factor for the infarct growth rate, and a faster infarct growth rate is a predictor of poor prognosis for elderly AIS patients after endovascular treatment.
