Mahmoud Fouad Mohamed, Mohamed Farag Sherien, Hegazy Mohamed I, Abd Elalem Aziz Mohamed
Neurology, Ain Shams University.
Neurology, Kasr Al Aini Hospital.
Cureus. 2017 Jun 26;9(6):e1392. doi: 10.7759/cureus.1392.
Introduction Determining the prognosis of ischemic stroke is important for neurologists and patients. The aim is to study the predictors of three months clinical outcome in ischemic stroke patients. Materials and methods A total of 397 patients were classified according to three months modified Rankin Scale score (mRS score) into two groups, favorable and unfavorable outcome. Favorable outcome was assumed if the score was zero or one, or unchanged if the score was ≥ 1 before the onset of the most recent event. Results The variables associated with unfavorable outcome were old age (<0.001), presence of cardiac disease (<0.001), low ejection fraction (=0.008), low levels of total cholesterol and low-density lipoproteins (<0.001), large artery atherosclerosis stroke (<0.001), early confluent (=0.005), high National Institute of Health stroke scale (NIHSS) score on admission (<0.001), mRS score before admission (<0.001), mRS score on discharge (<0.001). Lacunar stroke was associated with favorable outcome (<0.001). The regression analysis showed mRS score on discharge (<0.001) and the presence of cardiac diseases (=0.077) as independent predictors of unfavorable outcome. Conclusion High mRS score on discharge and presence of the cardiac disease independently could predict the unfavorable outcome and mRS score on discharge had a high sensitivity and negative predictive value in predicting the unfavorable outcome. Abbreviations MRS: score modified Rankin scale score, NIHSS: National Institutes of Health Stroke Scale, MRI: Magnetic resonance imaging, LDL: Low-density lipoprotein, MRA: Magnetic resonance of arteries.
引言 确定缺血性中风的预后对神经科医生和患者都很重要。目的是研究缺血性中风患者三个月临床结局的预测因素。材料与方法 总共397例患者根据三个月改良Rankin量表评分(mRS评分)分为两组,结局良好组和结局不良组。如果评分是零或一,则认为结局良好;如果在最近一次事件发作前评分≥1,则认为结局无变化。结果 与结局不良相关的变量有老年(<0.001)、存在心脏病(<0.001)、射血分数低(=0.008)、总胆固醇和低密度脂蛋白水平低(<0.001)、大动脉粥样硬化性中风(<0.001)、早期融合(=0.005)、入院时美国国立卫生研究院卒中量表(NIHSS)评分高(<0.001)、入院前mRS评分(<0.001)、出院时mRS评分(<0.001)。腔隙性中风与良好结局相关(<0.001)。回归分析显示,出院时mRS评分(<0.001)和存在心脏病(=0.077)是结局不良的独立预测因素。结论 出院时mRS评分高和存在心脏病可独立预测不良结局,且出院时mRS评分在预测不良结局方面具有高敏感性和阴性预测价值。缩写 MRS:改良Rankin量表评分,NIHSS:美国国立卫生研究院卒中量表,MRI:磁共振成像,LDL:低密度脂蛋白,MRA:动脉磁共振成像