The Diagnostic Value Of Posterior Circulatory Infarction Patients With Dizziness Was Predicted By Limb Ataxia Scores

Objectives: We are trying to establish a possible effective limb ataxia score(LAS)system,that will facilitate prediction of the positive diagnosis without laboratory or imaging examinations,and provide a certain clinical theoretical basis for early rapid identification,rational allocation of medical resources and rational referral of patients.Methods: All 180 patients who met the inclusion acceptance criteria in the First People’s Hospital of Huaihua,affiliated to the University of South China from January 2019 to December 2020 were selected and were divided into cerebral infarction group and non-cerebral infarction group.There were90 patients in each group.We selected 29 attributes for testing,of which 2were demographic characteristics,8 were past histories,7 were signs,9 were symptoms,and 2 were complications.In order to establish a binary logistic regression model,single factor and multivariate logistic regression analysis were used to determine the independent risk factors of Posterior Circulation Infarct(POCI)in patients with dizziness.And to establish the Limb Ataxia Score(LAS)system,the corresponding score was calculated according to the regression coefficient β value of each variable in the above model.The area under the curve(AUC)of the model and the LAS scoring system was compared with delong test,moreover,to know what differences of the predictive advantages of the LAS scores from ABCD2 and Essen scores.Results: The results of multivariate analysis of meaningful variables in the single factor were shown as below: diabetes(X1)(OR=16.362,95%CI(1.421-188.453),P=0.025),positive finger nose test with positive signs of other nerve localization(X2)(OR=147.274,95%CI(17.256-1256.908),P=0.000),positive rotation test with positive signs of other nerve localization(X3)(OR=38.147,95%CI(2.278-638.953),P=0.011),positive rotation test without other positive signs of nerve localization(X4)(OR=56.100,95%CI(6.842-460.014),P= < 0.001),follow-up A positive knee-tibia test with positive signs of other nerve localization(X5)(OR=30.700,95%CI(2.435-387.030),P=0.008),positive knee-tibia test without other positive signs of nerve localization(X6)(OR=10.852,95%CI(1.687-69.822),P=0.012),peripheral artery diseases(OR=5.302,95% CI(1.344-20.917),P=0.017)are an independent risk factor for POCI in patients with dizziness.The established probability prediction model formula:logit P=2.795*X1+4.992*X2+3.641*X3+4.027*X4+3.424*X5+2.384*X6+1.668*X7-5.474.We tried to establish a scoring system based on the regression coefficient β value of each variable in the model,with a total score of 0-10 points,X1(2 points),X7(1 point),X2(3 points),X3(2 points),X4(2points),X5(2 points),X6(1 point),by ROC curve evaluation,the AUC was0.853,95%CI(0.7999-0.907),the best cutoff value of the scoring system was 2 points,more than or the same as 2 were classified as high risk group,and less than 2 was classified as low risk group.After calculating the area under the AUC curve on the clinical common scale,the ABCD2 score(AUC:0.612,95% CI 0.535-0.689)and the Essen score(AUC: 0.707,95% CI0.633-0.781)were obtained.So,Compared the area under the AUC curve of LAS,ABCD2 and Essen scores,the predictive ability of the LAS scoring system was more advantages than that of the others.Conclusions:(1).Diabetes,peripheral arterial disease,positive finger nose test with positive signs of other nerves,positive rotation test with positive signs of other nerves,positive rotation test without other positive signs of nerves,positive knee-tibia test with other nerves Positive signs of localization and positive knee-tibia test without other positive signs of nerve localization,it might be predict factors of POCI.(2).There are predict value of constructed limb ataxia scale(LAS),due to its simple and functional,which is reference significance of clinical work.