From the Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
National Health Council Key Laboratory of Prevention and treatment of Cerebrovascular Disease, Henan, China.
Curr Neurovasc Res. 2022;19(2):232-239. doi: 10.2174/1567202619666220707094342.
Early neurological deterioration (END) often occurs during hospitalization in single small subcortical infarct (SSSI). While, symptoms on admission were rarely reported about its performance on predicting the risk of END.
The objective of this study is to explore the relationship between symptoms on admission and END in SSSI.
Patients with SSSI in the lenticulostriate artery (LSA) territory presenting within 72 hours of stroke onset were screened prospectively. Clinical characteristics, including symptoms on admission, laboratory tests and imaging findings, were collected. Based on the body regions involved including spherical face (SF), upper limb (UL) or lower limb (LL), symptoms on admission were classified into single spherical face (sSF) and any involvement of limbs (AL). END was defined as ≥2 points increase in total National Institutes of Health Stroke Scale (NIHSS) score or ≥ 1 point increase in motor score within 72 hours after admission. Multivariate logistic regression was used to analyze factors associated with END.
Out of 5,832 ischemic stroke patients in the database, 394 patients were finally enrolled in analysis. 65 patients (16.5%) developed END. Multivariable logistic regression revealed that symptoms with LL (OR 2.337, 95% CI 1.041-5.246), UL (OR 2.936, 95% CI 1.349-6.390) were both associated with END, while the involvement of SF (OR 0.447, 95% CI 0.249-0.804) showed the opposite result. Further analysis found that symptoms with AL (OR 3.958, 95% CI 1.355-11.565) showed a higher risk of END compared to sSF after adjustment.
Our results discovered that symptoms with AL carried a higher risk of END than those involving sSF in SSSI.
单发小皮质下梗死（SSSI）患者在住院期间常发生早期神经功能恶化（END）。然而，入院时的症状很少有报道其对 END 风险的预测作用。
本研究旨在探讨 SSSI 患者入院时症状与 END 之间的关系。
前瞻性筛选发病 72 小时内出现穿支动脉（LSA）区 SSSI 的患者。收集临床特征，包括入院时的症状、实验室检查和影像学发现。根据受累的身体区域，包括球形面（SF）、上肢（UL）或下肢（LL），将入院时的症状分为单一球形面（sSF）和任何肢体受累（AL）。END 定义为入院后 72 小时内 NIHSS 总分增加≥2 分或运动评分增加≥1 分。采用多变量 logistic 回归分析与 END 相关的因素。
在数据库中 5832 例缺血性脑卒中患者中，最终纳入 394 例进行分析。65 例（16.5%）发生 END。多变量 logistic 回归显示，下肢（OR 2.337，95%CI 1.041-5.246）和上肢（OR 2.936，95%CI 1.349-6.390）症状均与 END 相关，而 SF 受累（OR 0.447，95%CI 0.249-0.804）则相反。进一步分析发现，在调整后，AL 症状（OR 3.958，95%CI 1.355-11.565）与 sSF 相比，END 的风险更高。
我们的结果发现，在 SSSI 中，AL 症状比 sSF 症状更易发生 END。
