Prediction of favorable outcome by percent improvement in patients with acute ischemic stroke treated with endovascular stent thrombectomy

被引：19

作者：

Cao, Yuezhou ^{[1
,3
]}

Wang, Shuiping ^{[2
]}

Sun, Wen ^{[1
]}

Dai, Qiliang ^{[1
]}

Li, Wei ^{[1
]}

Cai, Jin ^{[1
]}

Fan, Xinying ^{[1
]}

Zhu, Wusheng ^{[1
]}

Xiong, Yunyun ^{[1
]}

Han, Yunfei ^{[1
]}

Zi, Wenjie ^{[1
]}

Yang, Shiquan ^{[2
]}

Chen, Jia ^{[2
]}

Liu, Xinfeng ^{[1
]}

机构：

[1] Southern Med Univ, Piling Hosp, Dept Neurol, Nanjing, Jiangsu, Peoples R China

[2] Peoples Liberat Army, Hosp 123, Dept Neurol, Bengbu, Anhui, Peoples R China

[3] Nanjing Med Univ, Affiliated Hosp 1, Dept Geriatr Neurol, Nanjing, Jiangsu, Peoples R China

来源：

JOURNAL OF CLINICAL NEUROSCIENCE | 2017年 / 38卷

基金：

中国国家自然科学基金;

关键词：

Acute ischemic stroke; Endovascular stent thrombectomy; ROC curve; Predictive factors; MAJOR NEUROLOGICAL IMPROVEMENT; INTRAVENOUS T-PA; THROMBOLYTIC TREATMENT; THERAPY; TRIAL; RECANALIZATION; REPERFUSION; STANDARD;

D O I：

10.1016/j.jocn.2016.12.045

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Our objective was to investigate a method for assessing early improvement and its predictive value for 3 month functional outcome in patients treated with EST. A total of 97 consecutive AIS patients undergoing EST were prospectively collected and retrospective reviewed. Data on demographics, vascular risk factors, admission National Institutes of Health Stroke Scale (NIHSS) score, 24-h NIHSS score, reperfusion and collateral formation were collected. Percent improvement was defined as ([baseline NIHSS score 24-h NIHSS score]/baseline NIHSS score x 100%), while absolute improvement was calculated by the difference between scores (baseline NIHSS score 24-h NIHSS score). A 3-month functional outcome was assessed using the modified Rankin Scale (mRS). Favorable outcome was defined as a mRS score of 0-2. Areas under the receiver-operating characteristic (ROC) curve (AUC) for percent improvement and absolute improvement in predicting favorable outcome was compared. Finally, we investigated the independent predictors of improvement at 24 h after EST and its relationship with favorable outcome. Pairwise comparison of ROC curves revealed that percent improvement had larger AUC than absolute improvement (p = 0.004). Rapid neurological improvement (RNI), defined as percent improvement >= 30%, was a powerful predictor of favorable outcome (odds ratio [OR] 7.63, confidence interval [CI]: 2.65-21.96; p < 0.001). Good collaterals (OR 2.86; 95% CI: 1.11-7.38; p = 0.030) and short onset-to-reperfusion time (ORT) (OR 3.02, 95% CI: 1.17-7.80; p= 0.022) were independent predictors of RNI. RNI predicted 3-month favorable outcome in AIS patients treated with EST. Good collaterals and short ORT are independent predictors of RNI. (C) 2017 Elsevier Ltd. All rights reserved.

引用

页码：100 / 105

页数：6

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