Guo Yikun, Zhang Min, Su Yan, Liu Jianfang, Fu Hongran, Wang Qian, Chen Yun
Department of Neurology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, People's Republic of China.
Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, People's Republic of China.
Neuropsychiatr Dis Treat. 2021 Nov 23;17:3431-3437. doi: 10.2147/NDT.S335274. eCollection 2021.
Few clinical indicators of a poor outcome have been defined in acute cardioembolic stroke (CES) patients. We would like to explore practical clinical factors that can predict poor outcomes of CES in the early stage.
In this single-center, retrospective, observational study, 251 consecutive patients with acute CES who did not undergo reperfusion therapy were evaluated. On the basis of the modified Rankin Scale (mRS) score at 3 months, patients were divided into the good functional outcome group (mRS ≤ 2) and the poor functional outcome group (mRS ≥ 3). Risk factors were analyzed and the independent indicators for a poor outcome were identified using a binary logistic regression model.
One hundred (39.8%) patients had a poor outcome. Patients in the poor outcome group were significantly older (P = 0.002) and had significantly higher baseline National Institutes of Health Stroke Scale (NIHSS) score compared with those with a good outcome (P < 0.001). After adjusting for potential confounders, the baseline NIHSS score (P < 0.001), moderate to severe leukoaraiosis (P = 0.011), non-symptomatic intracranial hemorrhage (P = 0.019), stroke-associated pneumonia (P = 0.001), and fasting glucose (P = 0.040) were independent risk factors for a poor outcome.
The short-term outcome in acute CES patients without reperfusion therapy can be predicted by using five practical clinical factors. These indicators should attract more attention.
急性心源性栓塞性卒中（CES）患者中，很少有已明确的预后不良临床指标。我们希望探索能在早期预测CES患者预后不良的实用临床因素。
在这项单中心、回顾性、观察性研究中，对251例未接受再灌注治疗的急性CES连续患者进行了评估。根据3个月时的改良Rankin量表（mRS）评分，将患者分为功能预后良好组（mRS≤2）和功能预后不良组（mRS≥3）。分析危险因素，并使用二元逻辑回归模型确定预后不良的独立指标。
100例（39.8%）患者预后不良。与预后良好的患者相比，预后不良组患者年龄显著更大（P = 0.002），基线美国国立卫生研究院卒中量表（NIHSS）评分显著更高（P < 0.001）。在调整潜在混杂因素后，基线NIHSS评分（P < 0.001）、中度至重度脑白质疏松（P = 0.011）、无症状颅内出血（P = 0.019）、卒中相关性肺炎（P = 0.001）和空腹血糖（P = 0.040）是预后不良的独立危险因素。
利用五个实用的临床因素可预测未接受再灌注治疗的急性CES患者的短期预后。这些指标应引起更多关注。
