Scholarlink

Introduction <p>This study aims to evaluate the clinical and imaging risk factors for early neurological deterioration (END) and long-term neurological disability in patients with Single subcortical small infarction (SSSI).</p> Methods <p>We retrospectively included SSSI patients hospitalized. Outcomes were defined as modified Rankin Scale (mRS) score &gt; 2 at follow-up and the occurrence of END during hospitalization. Multivariate logistic regression identified independent predictors of END and long-term outcomes. Stepwise regression analysis was used to develop a predictive model for poor outcomes. The predictive performance of risk factors and the model was assessed using receiver operating characteristic (ROC) curves.</p> Results <p>A total of 289 SSSI patients were included. During hospitalization, 18 patients (6.2%) experienced END, and 29 patients (10%) had neurological disability at a median follow-up of 21.4 (16.7–25.2) months. Multivariate analysis showed the National Institutes of Health Stroke Scale (NIHSS) score(OR 1.43, 95% CI 1.19–1.73, <i>P</i> &lt; 0.001), and neutrophil to high-density lipoprotein cholesterol ratio (NHR) (OR 1.28, 95% CI 1.02–1.60, <i>P</i> = 0.034) were independently associated with END. Age (OR 1.08, 95% CI 1.01–1.15, <i>P</i> = 0.028), NIHSS (OR 1.60, 95% CI 1.29–1.98, <i>P</i> &lt; 0.001), symptomatic intracranial artery stenosis (OR 5.26, 95% CI 1.56–17.71, <i>P</i> = 0.007), lacune number (OR 1.51, 95% CI 1.13–2.04, <i>P</i> = 0.006), the degree of brain atrophy (OR 2.03, 95% CI 1.19–3.46, <i>P</i> = 0.01), and mean hemoglobin concentration (MCHC) (OR 0.96, 95% CI 0.92–0.99, <i>P</i> = 0.04) were independently associated with neurological disability. The predictive model for END (included NIHSS score and NHR level) and long-term neurological disability (included age, NIHSS score, symptomatic intracranial artery stenosis, number of lacunes, and brain atrophy) showed areas under the ROC curve of 0.836 and 0.926, respectively.</p> Conclusion <p>High NIHSS and NHR are independent risk factors for END. Age, NIHSS, symptomatic intracranial artery stenosis, the number of lacunes, and brain atrophy are predictors of neurological disability in SSSI patients.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Clinical and imaging risk factors for early neurological deterioration and long-term neurological disability in patients with single subcortical small infarction

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年2月15日

查看全文
  • Xiao Feng,
  • Meiherinisa Taiwakuli,
  • Junyong Du,
  • Wenhao Zhu,
  • Shabei Xu

摘要

Introduction

This study aims to evaluate the clinical and imaging risk factors for early neurological deterioration (END) and long-term neurological disability in patients with Single subcortical small infarction (SSSI).

Methods

We retrospectively included SSSI patients hospitalized. Outcomes were defined as modified Rankin Scale (mRS) score > 2 at follow-up and the occurrence of END during hospitalization. Multivariate logistic regression identified independent predictors of END and long-term outcomes. Stepwise regression analysis was used to develop a predictive model for poor outcomes. The predictive performance of risk factors and the model was assessed using receiver operating characteristic (ROC) curves.

Results

A total of 289 SSSI patients were included. During hospitalization, 18 patients (6.2%) experienced END, and 29 patients (10%) had neurological disability at a median follow-up of 21.4 (16.7–25.2) months. Multivariate analysis showed the National Institutes of Health Stroke Scale (NIHSS) score(OR 1.43, 95% CI 1.19–1.73, P < 0.001), and neutrophil to high-density lipoprotein cholesterol ratio (NHR) (OR 1.28, 95% CI 1.02–1.60, P = 0.034) were independently associated with END. Age (OR 1.08, 95% CI 1.01–1.15, P = 0.028), NIHSS (OR 1.60, 95% CI 1.29–1.98, P < 0.001), symptomatic intracranial artery stenosis (OR 5.26, 95% CI 1.56–17.71, P = 0.007), lacune number (OR 1.51, 95% CI 1.13–2.04, P = 0.006), the degree of brain atrophy (OR 2.03, 95% CI 1.19–3.46, P = 0.01), and mean hemoglobin concentration (MCHC) (OR 0.96, 95% CI 0.92–0.99, P = 0.04) were independently associated with neurological disability. The predictive model for END (included NIHSS score and NHR level) and long-term neurological disability (included age, NIHSS score, symptomatic intracranial artery stenosis, number of lacunes, and brain atrophy) showed areas under the ROC curve of 0.836 and 0.926, respectively.

Conclusion

High NIHSS and NHR are independent risk factors for END. Age, NIHSS, symptomatic intracranial artery stenosis, the number of lacunes, and brain atrophy are predictors of neurological disability in SSSI patients.