| Objective:A retrospective study was conducted to study the prognostic factors of AIS patients undergoing endovascular therapy in the emergency department of the National Advanced Stroke Center of China-Japan Union Hospital of Jilin University.Method:In this article,acute-anterior circulation ischemic stroke patients who received endovascular treatment within 24 hours of onset from April 2019 to July 2022 from April 2019 to July 2022 were the subjects of this study of acute anterior circulation ischemic stroke patients who received endovascular therapy from April 2019 to July2022.The long-term prognosis was assessed by follow-up m RS scores 90 days after discharge.To investigate factors related to the prognosis of acute anterior circulation ischemic stroke with endovascular therapy.Outcome:1.A total of 215 cases were included in this study,which were divided into 2groups according to the m RS score of 3 months of follow-up and discharge,of which51 cases had a good prognosis(m RS score ≤ 2 points),accounting for 23.72% of the total number of cases,and 164 cases had a poor prognosis(m RS score ≥3 points),accounting for 76.28% of the total number of cases.Through the analysis of clinical data such as age,sex,baseline NIHSS score,ASPECT score at admission,history of tobacco and alcohol,history of previous underlying diseases,blood vessels responsible for onset,TOAST classification,surgical anesthesia mode,whether the blood vessel is stent or balloon dilation,postoperative bleeding transformation or pneumonia and other clinical data were analyzed,age(P=0.006),surgical anesthesia mode(P=0.014),homocysteine(P=0.006),There were significant differences in clinical data(P<0.05)between baseline NIHSS score(P=0.001),ASPECT at admission(P=0.015),postoperative concurrent pneumonia(P<0.001),NIHSS score(P<0.001)at 24 hours postoperative and NIHSS score(P<0.001)at discharge.The index of P<0.05 selected in the above univariate analysis and binary logistic regression analysis were statistically significant for the possible factors affecting the prognosis of patients undergoing endovascular therapy,and it was known that the age at the time of onset(P=0.044)and hyperhomocysteinemia(P=0.024)were statistically significant(P<0.05),the age at onset and the OR of hyperhomocysteinemia were 1.037 and 0.372,respectively,and the 95% confidence intervals were(1.001,1.074)and(0.158,0.876),respectively.2.Among the 215 patients included in this study,17 were discharged with death,accounting for 7.91% of the total number of patients included,and 36 patients died at 3-month follow-up after discharge,accounting for 16.74% of the total number of patients included.In the analysis of complications such as cerebral vascular collateral circulation and postoperative complications such as pneumonia and hemorrhagic transformation,there were significant differences(P<0.05)in clinical data such as age(P=0.016),cerebral collateral circulation(P=0.002),anesthesia mode(P=0.014),baseline NIHSS score(P=0.001),NIHSS score at 24 hours after surgery(P<0.001)and NIHSS score(P<0.001)at discharge.In univariate analysis(Table 4.5),the index of P<0.05 was selected and the possible factors affecting the prognosis of patients undergoing endovascular therapy were analyzed by binary logistic regression analysis,and it was found that the age at onset(P=0.031),high anesthesia mode(P=0.011),hemorrhagic transformation(P=0.002),and NIHSS score(P<0.001)at discharge were statistically significant(P<0.05),the OR values were 1.056,0.178,0.214,and 1.181,and the 95% confidence intervals were(1.005,1.109),(0.047,0.676),(0.082,0.560),and(1.110,1.258),respectively.Conclusion:1.Endovascular treatment of acute anterior circulation ischemic stroke can improve the prognosis of patients,and endovascular therapy should be started as soon as possible after evaluation of acute ischemic stroke patients.2.Age of onset and homocysteine level are independent factors influencing the prognosis of endovascular treatment of acute ischemic stroke.3.Age of onset,surgical anesthesia,and whether bleeding transformation is an independent risk factor affecting death from endovascular therapy,and the mortality rate of elderly patients,post-anesthesia patients,and patients with hemorrhagic transformation will be higher. |
PDF Full Text Request