Short-Term Prognostic Risk Factors and Nomogram Predictive Model Construction for Acute Ischaemic Stroke after Endovascular Treatment.

Boyu Chen, Ruoyu Deng, Yifei Chen, Xiang Ma, Guilin Jin, Sanxi Lei
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Abstract

Objective: To investigate the factors influencing the severity of acute ischaemic stroke (AIS) and short-term prognosis after endovascular treatment.

Study design: Observational study. Place and Duration of the Study: Department of Cerebrovascular Diseases, The First People's Hospital of Qujing City, Yunnan Province, China, from June 2020 to December 2022.

Methodology: An analysis was conducted on 160 AIS patients undergoing endovascular treatment, classified into atherosclerosis subtype (AS) and cardioembolic subtype (CE) based on the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification, each comprising 80 cases. The association among baseline and endovascular treatment parameters, clinical characteristics, postoperative complications, and short-term outcomes (risks of mortality and poor prognosis) was tested.

Results: Univariate analysis revealed significant positive correlations between increased fasting glucose, diastolic pressure, and the number of thrombectomy procedures with the frequency of cerebral haemorrhage in CE-type stroke. The time from femoral artery puncture to vessel opening was positively associated with the degree of brain oedema. In the AS subtype, univariate regression analysis demonstrated a significant association between heart rate, fasting glucose, cholesterol, time from femoral artery puncture to vessel opening, and degree of brain oedema with short-term prognosis. Fasting glucose and the number of thrombectomy procedures were significantly linked to short-term prognosis in CE-type AIS. A predictive model using line charts was developed for factors associated with postoperative complications and short-term prognosis, achieving predictive accuracies of 95.5% for the risk of death and 92.7% for poor prognosis (mRS >2), notably surpassing traditional prediction methods.

Conclusion: Clinical characteristics and endovascular treatment-related factors are important for the short-term prognosis of AIS patients. Development of predictive models can efficiently identify high-risk patients at an early stage.

Key words: Acute ischaemic stroke, Atherosclerosis, Cardioembolic, Severity, Prognosis.

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血管内治疗后急性缺血性脑卒中的短期预后风险因素和Nomogram预测模型构建。
研究目的研究设计:观察性研究:观察性研究。研究地点和时间研究地点和时间:中国云南省曲靖市第一人民医院脑血管病科,2020年6月至2022年12月:对160例接受血管内治疗的AIS患者进行分析,根据ORG 10172急性卒中治疗试验(TOAST)将患者分为动脉粥样硬化亚型(AS)和心肌栓塞亚型(CE),各80例。测试了基线和血管内治疗参数、临床特征、术后并发症和短期预后(死亡和预后不良风险)之间的关联:单变量分析显示,空腹血糖升高、舒张压升高和血栓切除术次数与 CE 型脑卒中脑出血发生率呈显著正相关。股动脉穿刺至血管开放的时间与脑水肿程度呈正相关。在 AS 亚型中,单变量回归分析表明心率、空腹血糖、胆固醇、股动脉穿刺至血管开放的时间和脑水肿程度与短期预后有显著相关性。空腹血糖和血栓切除术次数与CE型AIS患者的短期预后有明显关系。针对与术后并发症和短期预后相关的因素,利用折线图建立了一个预测模型,对死亡风险的预测准确率达到了95.5%,对不良预后(mRS>2)的预测准确率达到了92.7%,明显超过了传统的预测方法:结论:临床特征和血管内治疗相关因素对AIS患者的短期预后非常重要。结论:临床特征和血管内治疗相关因素对 AIS 患者的短期预后非常重要,开发预测模型可在早期有效识别高危患者:急性缺血性卒中、动脉粥样硬化、心肌栓塞、严重程度、预后。
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