后循环卒中后成功取栓后预后影响因素分析

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-05-04 DOI:10.1016/j.clineuro.2025.108948

Qin Wang , Wenxuan Zhao , Junwei Qian , Ziyu Sun , Bao He , Lei Shi , Xiaojie Lu

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引用次数: 0

摘要

目的随着机械取栓（MT）技术的不断提高，血管再通成功率显著提高，但仍有部分患者基于血管再通的预后较差。本研究旨在寻找影响血管再通术后预后的临床因素，寻找有价值的预测因子。方法对行后循环取栓术的患者随访180天。使用单变量和多变量逻辑回归，我们确定了与功能结局或生存相关的预后因素。进一步应用Cox分析确定这些因素的最佳截止值。结果改良的脑梗死溶栓（mTICI）和NIHSS（24 h）作为独立的预后因素，可为患者90天内的预后状况提供可靠的指示。此外，较低的后循环阿尔伯塔卒中计划早期CT评分（pc-ASPECTs）评分和较高的NIHSS（24 h）评分与患者的90天生存状态密切相关。结论回顾性分析取栓后NIHSS（24 h）是影响患者康复预后和死亡的关键独立预后因素，有助于临床决策和术后护理。

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Analysis of factors associated with prognosis after successful thrombectomy after posterior circulation stroke

Purpose

With the continuous improvement of mechanical thrombectomy (MT) technology, the success rate of vascular recanalization has been significantly improved, and some patients still have poor prognosis based on vascular recanalization. This study aims to find clinical factors affecting prognosis after vascular recanalization and find valuable predictors.

Methods

We followed up patients who underwent posterior circulation thrombectomy for up to 180 days. Using univariate and multivariate logistic regression, we identified prognostic factors related to functional outcomes or survival. Cox analysis was further applied to determine the optimal cutoff values for these factors.

Results

Modified Thrombolysis in Cerebral Infarction (mTICI) and NIHSS (24 h), as independent prognostic factors, provide a reliable indication of patients' prognostic status within 90 days. Additionally, a lower Posterior Circulation Alberta Stroke Program Early CT Score (pc-ASPECTs) score and a higher NIHSS (24 h) score are closely associated with patients' 90-day survival status.

Conclusion

Retrospective analysis after thrombectomy showed that NIHSS (24 h) was a key independent prognostic factor for the rehabilitation prognosis and death of patients, which was helpful for clinical decision-making and postoperative care.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.