IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY World neurosurgery Pub Date : 2025-01-23 DOI:10.1016/j.wneu.2025.123693
Baorui Zhang, Aixin Liu, Tong Lai, Sisi Wang, Wei Lu, Mingxing Wang, Yonglei Zhu
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摘要

背景:本研究分析了急性缺血性脑卒中(AIS)患者接受机械取栓术(MT)后90天预后的影响因素,并建立了预测术后90天预后的多维风险模型:对本院接受机械取栓术的 AIS 患者的临床数据进行了回顾性分析。研究共纳入了 111 名符合纳入标准的患者。根据术后3个月随访记录中的改良Rankin量表(mRS)评分,将患者分为预后良好组(88例,79.28%)和预后不良组(23例,20.72%)。使用 MedCalc 软件绘制接收者操作特征曲线(ROC),并计算曲线下面积(AUC)值,建立风险预测模型,以提名图的形式呈现:逻辑回归分析显示,C反应蛋白(T3)(p < 0.001)、入院时的NIHSS评分(p = 0.001)和心房颤动病史(p = 0.004)是不良预后的独立预测因素,而白蛋白(T2)(p = 0.008)则是90天预后的保护因素。这些因子的 AUC 值分别为 0.812、0.760、0.655 和 0.757。Normotu 的 AUC 值为 0.945。校准斜率=0.856,大校准≈0,观察/预期(O/E)比值≈1.结论:MT后CRP水平、入院时NIHSS评分和心房颤动病史与这些患者的不良预后显著相关。此外,较高的内源性白蛋白水平是 MT 后 AIS 患者 3 个月预后的保护因素。
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Predictive value of dynamic changes in inflammatory markers within 24 hours after mecha nical thrombectomy for outcome in patients with acute ischemic stroke.

Background: This study analyzes the factors influencing the 90-day prognosis of acute ischemic stroke (AIS) patients after mechanical thrombectomy (MT) and established a multidimensional risk model to predict postoperative 90-day outcomes.

Methods: A retrospective analysis of clinical data was conducted for AIS patients who underwent MT at our hospital. A total of 111 patients who met the inclusion criteria were included in the study. Based on the modified Rankin Scale (mRS) scores from follow-up records at 3 months post-surgery, the patients were divided into a good prognosis group (88 cases, 79.28%), a poor prognosis group (23 cases, 20.72%). Receiver operating characteristic (ROC) curves were plotted using MedCalc software, and area under the curve (AUC) values were calculated to establish a risk prediction model, presented in the form of a nomogram.

Results: Logistic regression analysis showed that C-reactive protein (T3) (p < 0.001), NIHSS score at admission (p = 0.001), and a history of atrial fibrillation (p = 0.004) were independent predictors of poor prognosis, while albumin (T2) (p = 0.008) was a protective factor for the 90-day outcome. The AUC values for these factors were 0.812, 0.760, 0.655, and 0.757, respectively. The AUC values of Normotu was 0.945. Calibration slope = 0.856, Calibration-in-the-Large ≈ 0, and Observed/Expected (O/E) ratio ≈ 1.

Conclusion: Post-MT CRP levels, NIHSS score at admission, and a history of atrial fibrillation are significantly associated with poor prognosis in these patients. Moreover, higher levels of endogenous albumin are a protective factor for the 3-month prognosis of AIS patients after MT.

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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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