Yan Shi, Yongtao Liu, Jingjing Sun, Bing Zhao, Qingfan Xie
{"title":"小动脉闭塞或腔隙性脑卒中后不良预后的危险因素分析：一项回顾性队列研究。","authors":"Yan Shi, Yongtao Liu, Jingjing Sun, Bing Zhao, Qingfan Xie","doi":"10.2147/RMHP.S482736","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors and predictive value for poor prognosis following small artery occlusion stroke (SAO) or lacunar stroke.</p><p><strong>Methods: </strong>A retrospective cohort of 100 SAO patients who received their first intravenous thrombolysis (IVT) treatment with alteplase between March 2019 and March 2021 was collected. Based on the modified Rankin Scale (mRS) score of <3 at 90 days post-admission, patients were divided into a good prognosis group (61 cases) and a poor prognosis group (39 cases) for comparative analysis.</p><p><strong>Results: </strong>In our retrospective cohort study of 100 SAO patients treated with IVT from March 2019 to March 2021, we found no significant differences in gender, age or BMI between the 61 patients with good prognosis and the 39 with poor prognosis, although smoking habits varied. Statistically differences were observed between the two groups in terms of time from onset to hospital admission for thrombolysis (48.59±20.14 vs 40.03±23.73 min, <i>t</i>=2.202, <i>P</i>=0.030), triglycerides (1.56±0.92 vs 1.20±0.68 mmol/L, <i>t</i>=2.069, <i>P</i>=0.041), and smoking prevalence (42.62% vs 20.51%, <i>χ<sup>2</sup></i> =5.183, <i>P</i>=0.023). Regression analysis indicated that shorter time from onset to hospital admission for thrombolysis (<i>OR</i>=0.978, 95% CI: 0.957-0.993) was a protective factor against poor prognosis post-thrombolysis in SAO patients, while a history of smoking (<i>OR</i>=2.881, 95% CI: 1.115-7.444) was a risk factor for poor prognosis post-thrombolysis. The area under the curve (AUC) for predicting poor prognosis post-thrombolysis in SAO patients based on time from onset to hospital admission was 0.662 (95% CI: 0.552-0.771), with a cutoff value of 36.5 min; the AUC for predicting poor prognosis based on smoking history was 0.614 (95% CI: 0.502-0.726).</p><p><strong>Conclusion: </strong>An extended duration from onset to hospital admission for thrombolysis and smoking are identified as significant risk factors for poor prognosis following thrombolysis in SAO patients, both of which have substantial predictive value.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"915-922"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928325/pdf/","citationCount":"0","resultStr":"{\"title\":\"Analysis of Risk Factors for Poor Prognosis Following Small Artery Occlusion or Lacunar Stroke: A Retrospective Cohort Study.\",\"authors\":\"Yan Shi, Yongtao Liu, Jingjing Sun, Bing Zhao, Qingfan Xie\",\"doi\":\"10.2147/RMHP.S482736\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the risk factors and predictive value for poor prognosis following small artery occlusion stroke (SAO) or lacunar stroke.</p><p><strong>Methods: </strong>A retrospective cohort of 100 SAO patients who received their first intravenous thrombolysis (IVT) treatment with alteplase between March 2019 and March 2021 was collected. Based on the modified Rankin Scale (mRS) score of <3 at 90 days post-admission, patients were divided into a good prognosis group (61 cases) and a poor prognosis group (39 cases) for comparative analysis.</p><p><strong>Results: </strong>In our retrospective cohort study of 100 SAO patients treated with IVT from March 2019 to March 2021, we found no significant differences in gender, age or BMI between the 61 patients with good prognosis and the 39 with poor prognosis, although smoking habits varied. Statistically differences were observed between the two groups in terms of time from onset to hospital admission for thrombolysis (48.59±20.14 vs 40.03±23.73 min, <i>t</i>=2.202, <i>P</i>=0.030), triglycerides (1.56±0.92 vs 1.20±0.68 mmol/L, <i>t</i>=2.069, <i>P</i>=0.041), and smoking prevalence (42.62% vs 20.51%, <i>χ<sup>2</sup></i> =5.183, <i>P</i>=0.023). Regression analysis indicated that shorter time from onset to hospital admission for thrombolysis (<i>OR</i>=0.978, 95% CI: 0.957-0.993) was a protective factor against poor prognosis post-thrombolysis in SAO patients, while a history of smoking (<i>OR</i>=2.881, 95% CI: 1.115-7.444) was a risk factor for poor prognosis post-thrombolysis. The area under the curve (AUC) for predicting poor prognosis post-thrombolysis in SAO patients based on time from onset to hospital admission was 0.662 (95% CI: 0.552-0.771), with a cutoff value of 36.5 min; the AUC for predicting poor prognosis based on smoking history was 0.614 (95% CI: 0.502-0.726).</p><p><strong>Conclusion: </strong>An extended duration from onset to hospital admission for thrombolysis and smoking are identified as significant risk factors for poor prognosis following thrombolysis in SAO patients, both of which have substantial predictive value.</p>\",\"PeriodicalId\":56009,\"journal\":{\"name\":\"Risk Management and Healthcare Policy\",\"volume\":\"18 \",\"pages\":\"915-922\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-03-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928325/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Risk Management and Healthcare Policy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/RMHP.S482736\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Risk Management and Healthcare Policy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/RMHP.S482736","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Analysis of Risk Factors for Poor Prognosis Following Small Artery Occlusion or Lacunar Stroke: A Retrospective Cohort Study.
Objective: To investigate the risk factors and predictive value for poor prognosis following small artery occlusion stroke (SAO) or lacunar stroke.
Methods: A retrospective cohort of 100 SAO patients who received their first intravenous thrombolysis (IVT) treatment with alteplase between March 2019 and March 2021 was collected. Based on the modified Rankin Scale (mRS) score of <3 at 90 days post-admission, patients were divided into a good prognosis group (61 cases) and a poor prognosis group (39 cases) for comparative analysis.
Results: In our retrospective cohort study of 100 SAO patients treated with IVT from March 2019 to March 2021, we found no significant differences in gender, age or BMI between the 61 patients with good prognosis and the 39 with poor prognosis, although smoking habits varied. Statistically differences were observed between the two groups in terms of time from onset to hospital admission for thrombolysis (48.59±20.14 vs 40.03±23.73 min, t=2.202, P=0.030), triglycerides (1.56±0.92 vs 1.20±0.68 mmol/L, t=2.069, P=0.041), and smoking prevalence (42.62% vs 20.51%, χ2 =5.183, P=0.023). Regression analysis indicated that shorter time from onset to hospital admission for thrombolysis (OR=0.978, 95% CI: 0.957-0.993) was a protective factor against poor prognosis post-thrombolysis in SAO patients, while a history of smoking (OR=2.881, 95% CI: 1.115-7.444) was a risk factor for poor prognosis post-thrombolysis. The area under the curve (AUC) for predicting poor prognosis post-thrombolysis in SAO patients based on time from onset to hospital admission was 0.662 (95% CI: 0.552-0.771), with a cutoff value of 36.5 min; the AUC for predicting poor prognosis based on smoking history was 0.614 (95% CI: 0.502-0.726).
Conclusion: An extended duration from onset to hospital admission for thrombolysis and smoking are identified as significant risk factors for poor prognosis following thrombolysis in SAO patients, both of which have substantial predictive value.
期刊介绍：
Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include:
Public and community health
Policy and law
Preventative and predictive healthcare
Risk and hazard management
Epidemiology, detection and screening
Lifestyle and diet modification
Vaccination and disease transmission/modification programs
Health and safety and occupational health
Healthcare services provision
Health literacy and education
Advertising and promotion of health issues
Health economic evaluations and resource management
Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.
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