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老年患者前循环急诊大血管闭塞机械取栓的预测因素。

Predictors of Mechanical Thrombectomy for Anterior Circulation Emergent Large-Vessel Occlusion in the Older Adults.

机构信息

Department of Neurology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China.

Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China.

出版信息

Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231184219. doi: 10.1177/10760296231184219.

Abstract

Few studies have reported the clinical outcomes of older adult patients with acute anterior circulation large-vessel occlusion (LVO) who underwent mechanical thrombectomy (MT). Therefore, we investigated the safety, functional outcomes, and predictors of MT for anterior circulation LVO in older adults. We enrolled patients with acute anterior circulation LVO from May 2018 to October 2021 in this retrospective study. Patients were divided into older (≥80 years) and young (<80 years) groups. Multivariable logistic regression analyses determined the safety, functional outcomes, and predictors of MT for anterior circulation LVO. We divided 1182 patients with acute ischemic stroke into young (18-79 years; 1028 patients) and older (≥80 years; 154 patients) groups. Compared with the young group, the older group had more unfavorable functional outcomes and increased mortality ( = .003). In the older adult patients, lower initial NIHSS score and higher ASPECTS were correlated with good outcomes. On the contrary, higher initial NIHSS score and lower ASPECTS were related to increased mortality. No difference was detected in symptomatic intracranial hemorrhage within 48 h between two groups. Increasing age was associated with lower rates of favorable functional outcomes and higher mortality rates. The lower initial NIHSS score combined with the higher ASPECTS may predict functional outcomes post-thrombectomy in older adults.

摘要

很少有研究报道接受机械取栓 (MT) 的老年急性前循环大血管闭塞 (LVO) 患者的临床转归。因此,我们研究了 MT 治疗老年急性前循环 LVO 的安全性、功能结局和预测因素。我们回顾性研究了 2018 年 5 月至 2021 年 10 月期间患有急性前循环 LVO 的患者。患者分为老年(≥80 岁)和年轻(<80 岁)组。多变量逻辑回归分析确定了 MT 治疗前循环 LVO 的安全性、功能结局和预测因素。我们将 1182 例急性缺血性脑卒中患者分为年轻组(18-79 岁;1028 例)和老年组(≥80 岁;154 例)。与年轻组相比,老年组的功能结局较差,死亡率较高(=0.003)。在老年患者中,较低的初始 NIHSS 评分和较高的 ASPECTS 与良好的结局相关。相反,较高的初始 NIHSS 评分和较低的 ASPECTS 与死亡率增加相关。两组在 48 小时内症状性颅内出血无差异。年龄的增加与良好的功能结局率降低和死亡率增加相关。较低的初始 NIHSS 评分结合较高的 ASPECTS 可能预测老年患者取栓后的功能结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c061/10327998/3f4b916c94d3/10.1177_10760296231184219-fig1.jpg

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