An Association Study Of Post-stroke Cognitive Impairment With TOAST Classification And Other Risk Factors

Objective: Clarify the correlation between Post-stroke Cognitive Impairment and TOAST classification and other risk factors,in order to help early identification and early intervention of risk factors.Methods:Patients with acute ischemic stroke who were hospitalized in the Department of Neurology of the Second Hospital of Hebei Medical University from January 1,2019 to December 31,2019 were scored with the Mini-Mental Sate Examination and Montreal Cognitive Assessment.All patients were divided into PSCI group and Post-stroke Non-Cognitive Impairment group(PSNCI).All patients completed head MRI/CT,electrocardiogram,cervical vascular ultrasound examination and TOAST classification.Independent sample t-test,Chi-square test,Mann-Whitney U test,Binary Logistic regression and other methods were used for analysis.Results: A total of 184 patients with acute ischemic stroke were included in this study,including PSCI group(n﹦107)and PSNCI group(n﹦77).The incidence of PSCI was 58%.Statistical analysis showed that age,education level,history of hypertension,high glycated hemoglobin,hemoglobin,obesity,NIHSS score,median stroke,Large-artery atherosclerosis stroke,Small-artery occlusion stroke had significant differences(P ﹤ 0.05)between PSCI and PSNCI group.Among them,older age,lower education age,lower hemoglobin,high glycated hemoglobin,median stroke and LAA stroke may be the risk factors of PSCI,history of hypertension and obesity may be the protective factors of PSCI.In patients with SAO stroke,education level,history of hypertension,median stroke,limbic system infarction and thalamic infarction,anterior circulation infarction were significantly different(P﹤0.05)between PSCI and PSNCI group.Among them,lower education age,higher NIHSS score,median stroke,limbic system infarction and thalamic infarction,anterior circulation infarction may be the risk factors of PSCI.Binary Logistic regression analysis showed that lower education age(OR:0.775,95%CI:0.654-0.918),higher NIHSS score(OR:1.511,95%CI: 1.097-2.080)and anterior circulation infarction(OR:6.245,95%CI: 1.672-23.330)were independent risk factors for PSCI in patients with SAO stroke.Conclusions:PSCI is a common clinical manifestation in patients with acute ischemic stroke.Older age,lower education age,high glycated hemoglobin,lower hemoglobin,median stroke and LAA stroke may be the risk factors of PSCI,history of hypertension and obesity may be the protective factors of PSCI.In patients with SAO stroke,lower education age,higher NIHSS score and anterior circulation infarction were independent risk factors for PSCI.