接受血管内治疗的大面积核心梗塞患者的美国国立卫生研究院卒中量表评分与临床结果之间的关系。

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY Neurology and Therapy Pub Date : 2024-06-01 Epub Date: 2024-03-01 DOI:10.1007/s40120-024-00588-8

Lingyu Zhang, Jinfu Ma, Mengmeng Wang, Lin Zhang, Wenzhe Sun, Honghong Ji, Chengsong Yue, Jiacheng Huang, Wenjie Zi, Fengli Li, Changwei Guo, Pengfei Wang

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引用次数: 0

摘要

导言：本研究旨在分析接受血管内治疗（EVT）的大核心梗死患者的美国国立卫生研究院卒中量表（NIHSS）基线评分与临床预后之间的关系：数据来自 MAGIC 研究，这是一项前瞻性多中心队列研究，主要针对急性大核心缺血性卒中患者。该分析评估了 NIHSS 评分对大核心梗死患者 EVT 治疗效果的影响。主要结果指标包括良好结果（90 天时改良 Rankin 量表 [mRS] 为 0-3），次要结果包括 mRS 评分的变化、功能独立性（mRS 评分为 0-2）、mRS 评分为 0-4 和再通成功率。不良事件包括症状性颅内出血（sICH）和死亡率：共有 490 名患者参与了这项研究。较高的基线 NIHSS 评分与良好的预后成反比（模型 3 中的调整赔率比 [OR]，0.848 [0.797-0.903]，P 结论：研究结果表明，较高的基线 NIHSS 评分与良好的预后成反比：研究结果表明，基线 NIHSS 评分越高，预后越差，死亡率越高，尤其是当评分超过 20 分时。此外，年龄和性别通过与基线 NIHSS 评分的关联间接影响了良好的预后。

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The Association Between National Institutes of Health Stroke Scale Score and Clinical Outcome in Patients with Large Core Infarctions Undergoing Endovascular Treatment.

Introduction: This study aimed to analyze the association between baseline National Institutes of Health Stroke Scale (NIHSS) scores and clinical outcomes in patients with large core infarctions undergoing endovascular treatment (EVT), a relationship that remains unclear.

Methods: Data were obtained from the MAGIC study, a prospective multicenter cohort study focusing on patients with acute large core ischemic stroke. This analysis evaluated the impact of NIHSS scores on EVT outcomes in patients with large core infarctions. Primary outcome metrics included favorable outcomes (modified Rankin Scale [mRS] of 0-3 at 90 days), while secondary outcomes encompassed shifts in mRS scores, functional independence (mRS score of 0-2), mRS score of 0-4, and successful recanalization rates. Adverse events considered were symptomatic intracranial hemorrhage (sICH) and mortality.

Results: A total of 490 patients were enrolled in this study. Higher baseline NIHSS scores were inversely correlated with favorable outcomes (adjusted odds ratio [OR] in model 3, 0.848 [0.797-0.903], P < 0.001), particularly in patients with NIHSS scores above 20 (adjusted OR in model 3, 0.518 [0.306-0.878] vs. 0.290 [0.161-0.523]). Regarding adverse events, higher baseline NIHSS scores significantly correlated with increased 90-day mortality rates (adjusted OR in model 3, 1.129 [1.072-1.189], P < 0.001). This correlation became insignificant when baseline NIHSS scores exceeded 22. Additionally, baseline NIHSS scores partially mediated the association between age (indirect effect = - 0.0005, 19.39% mediated) and sex (indirect effect = 0.0457, 25.08% mediated) with the primary outcome.

Conclusions: The findings indicate that higher baseline NIHSS scores correlate with poorer outcomes and increased mortality, particularly when scores exceed 20. Moreover, age and sex indirectly influence favorable outcomes through their association with baseline NIHSS scores.

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来源期刊

Neurology and Therapy CLINICAL NEUROLOGY-

CiteScore

5.40

自引率

8.10%

发文量

103

审稿时长

6 weeks

期刊介绍： Aims and Scope Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice. Neurology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. 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