一种用于预测急性缺血性脑卒中患者机械取栓后预后的新型列线图。

A Novel Nomogram for Predicting Prognosis after Mechanical Thrombectomy in Patients with Acute Ischemic Stroke.

机构信息

General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006,China.

Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006,China.

出版信息

Curr Neurovasc Res. 2021;18(5):479-488. doi: 10.2174/1567202618666211210154739.

DOI:10.2174/1567202618666211210154739

PMID:34895124

Abstract

BACKGROUND

Mounting evidence has shown that mechanical thrombectomy (MT) improves clinical outcomes for large vessel occlusions (LVOs) in patients with acute ischemic stroke (AIS) of the anterior circulation. The present study aimed to provide a comprehensive analysis of risk factors associated with clinical outcomes in AIS patients receiving MT.

METHODS

A total of 212 consecutive patients who underwent MT for AIS were enrolled in the present study. Clinical characteristics were recorded at admission. Two endpoints were defined according to the 3-month modified Rankin scale (mRS) score after AIS (good outcome, mRS 0-2; and death, mRS 6). Additionally, we compared the clinical outcomes and safety of MT alone and bridging therapy in AIS patients.

RESULTS

Of the 212 patients treated with MT, 114 (53.77%) patients had a good outcome and 31 (14.62%) died. The incidence of a worse outcome after MT was significantly elevated in males and patients with high WBC counts, high admission blood glucose levels, high baseline NIHSS scores and a long interval time from groin puncture to reperfusion in AIS patients treated with MT after adjustment for covariates (P<0.05); these risk factors were further confirmed by our constructed nomograms. In addition, we observed no significant benefit of bridging therapy compared to MT alone in AIS patients.

CONCLUSION

Our constructed nomogram based on male sex, admission WBC, admission blood glucose, NIHSS, and the interval time from groin puncture to reperfusion predicts prognosis after mechanical thrombectomy in patients with acute ischemic stroke.

摘要

背景

越来越多的证据表明，机械取栓（MT）可改善急性缺血性脑卒中（AIS）前循环大血管闭塞（LVOs）患者的临床结局。本研究旨在综合分析接受 MT 的 AIS 患者与临床结局相关的危险因素。

方法

本研究共纳入 212 例接受 MT 治疗的 AIS 患者。入院时记录临床特征。根据 AIS 后 3 个月改良 Rankin 量表（mRS）评分（良好结局，mRS 0-2；死亡，mRS 6）定义了两个终点。此外，我们比较了 MT 单独治疗和桥接治疗在 AIS 患者中的临床结局和安全性。

结果

212 例接受 MT 治疗的患者中，114 例（53.77%）患者预后良好，31 例（14.62%）死亡。校正协变量后，MT 治疗的 AIS 患者中，男性和白细胞计数高、入院血糖水平高、基线 NIHSS 评分高、股动脉穿刺至再灌注时间长的患者 MT 后不良结局的发生率显著升高（P<0.05）；这些危险因素在我们构建的列线图中得到了进一步证实。此外，与 MT 单独治疗相比，桥接治疗对 AIS 患者没有显著获益。