Factors Of Infarct Core Volume And Its Correlation With Clinical Outcome In Patients With Acute Anterior Circulation Large Vessel Occlusive Stroke

Objective: To analyze the influencing factors of infarct core volume(ICV)size in patients with acute anterior circulation large vessel occlusive stroke(ALVOS),and to evaluate the correlation between ICV size and clinical prognosis.Methods:A total of 62 patients with ALVOS admitted to the Department of Neurology,Handan Central Hospital from January 2022 to September 2022 were retrospectively collected,including 40 males and 22 females,with an average aged 65.55 years.The patients were divided into the small-infarct core volume(S-ICV)group(ICV <50 m L,n=38)and the large-infarct core volume(L-ICV)group(ICV≥50 m L,n=24)according to the ICV,the differences in clinical characteristics between the two groups were compared.Multivariate Logistic regression was used to analyze the independent influencing factors of L-ICV.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of ICV for the clinical prognosis of ALVOS patients.Kaplan-Meier survivalanalysis was used to explore the effect of ICV on the survival of patients.Cox regression analysis was used to analyze the risk factors of death in patients with ALVOS complicated with L-ICV.Results: Compared with patients with S-ICV,patients with L-ICV had higher National Institutes of Health Stroke Scale(NIHSS)score andhemoglobin concentration.The regional leptomeningeal collateral(r LMC)score and the proportion of history of hypertension were lower(P<0.05).Multivariate Logistic regression analysis showed that high hemoglobin concentration [odds ratio(OR)=1.082,95%confidence interval(CI):1.020～1.148;P=0.009] was an independent risk factor for L-ICV,while high r LMC(OR=0.788,95%CI:0.678～0.916;P=0.002)were the protectivefactors for L-ICV.Compared with the S-ICV group,the L-ICV group had a lower90-day good prognosis rate(36.8% vs 8.3%,P=0.012)and a higher mortality rate(7.9% vs 62.5%,P=0.000).while there was no significant difference in Symptomatic intracranial hemorrhage(s ICH)within 24 hours and the treatment plan between the two groups(P>0.05).To distinguish good and poor prognosis,the cutoff value of ICV is 52.55 m L.Kaplan-Meier survival analysis showed that the cumulative survival rate of patients in the L-ICV group was significantly lower than that in the S-ICV group(P<0.05).Further subgroup analysis of the L-ICV group showed that the results of multivariate Cox risk regression analysis showed that s ICH(HR=28.855,95%CI:2.975～279.849,P < 0.05)and diabetes(HR=13.832,95%CI:1.040～183.820,P<0.05)were independent risk factors for survival in L-ICV group.Conclusions:1.High hemoglobin concentration is an independent risk factor for L-ICV in patients with ALVOS,while high r LMC score is a protective factor.2.ICV size has a good predictive value for the prognosis of patients with ALVOS.3.The good prognosis rate and cumulative survival rate of L-ICV group were significantly lower than those of S-ICV group.s ICH and diabetes are independent survival factors for L-ICV patients.