The Predictive Value Of LAMS+gaze In Acute Anterior Circulation Large Artery Occlusion Cerebral Infarction

Objective: We added cortical symptom "gaze" to the Los Angeles Motor Scale to form "LAMS+ gaze" scale,and verified its predictive value in patients with acute large vessel cerebral infarction.Methods: Data were continuously collected from patients with acute anterior circulation cerebral infarction who were treated in the Department of Neurology of our hospital from September 2018 to December 2019 for a retrospectively studied.,and then a retrospective study was conducted.All the enrolled patients were examined by Digital Subtraction Angiography,CT Angiography or Magnetic Resonance Angiography.According to the results of imaging examination,the patients were divided into two groups: the large artery vessel occlusion group and the non-large artery vessel occlusion group.General data of all enrolled patients were collected,including clinical symptoms and signs,medical history,imaging examination results,etc.Chi-square test and t test was used to analysis the general information.Binary Logistics analysis was used to explore whether "LAMS+gaze" can be used as an independent risk factor for large artery vessel occlusion in patients with acute anterior circulation infarction our different stroke scales were applied.By drawing the Receiver Operating Characteristic curve(ROC)and calculating the area under the curve and the specificity,sensitivity and optimal truncation value of the above scales were calculated,and the prediction accuracy of "NIHSS","FAST-ED","LAMS" and "LAMS+gaze" for acute anterior circulation large artery vessel occlusion was analyzed.Results: A total of 136 patients were collected,including 48 in the large artery vessel occlusion group and 88 in the non-large artery vessel occlusion group,the average age of the male(29/56)and female patients(19/32)was 61.54±11.94 and63.61±11.64 years old.In general data analysis,the percentage of patients with atrial fibrillation,the NIHSS score,the LAMS score,and the “LAMS+gaze” score were all obviously higher in the large artery vessel occlusion group than the other one.Further logistics regression analysis of all statistically significant items showed that atrial fibrillation,NIHSS score,LAMS score and "LAMS+gaze" score were all independent risk factors for great artery vessel occlusion.FAST-ED score was not an independent risk factor for aortic occlusion.The areas under the ROC curve calculated on the basis of these four scoring scales were 0.805,0.748,0.790 and 0.865.The optimal cut-off value of NIHSS score was 7.5,the sensitivity and specificity were 72.9% and 72.7%.The best cut-off value of FAST-ED score was 3.5,the sensitivity was 52.1% and the specificity was 81.8%.The best cut-off value of LAMS score was 3.5,the sensitivity and specificity were 54.2% and 87.5%.The best cut-off value of "LAMS+gaze" was3.5,the sensitivity and specificity were 81.3% and 81.8%.Conclusion: In this study,the high score of "LAMS+gaze" was an independent risk factor of LAVO.When the score of "LAMS+gaze" was ≥3.5 points,it indicated that the patient had a high possibility of LAVO.Compared with the LAMS score and other stroke severity screening scales."LAMS+gaze" was more effective in predicting acute large artery vessel occlusion.