Risk factors of early neurological deterioration in patients with acute posterior circulation infarction
Objective To observe the occurrence of early neurological deterioration(END)in patients with acute posterior circulation infarction(APCI),and to investigate the risk factors and prognosis.Methods A total of 316 patients with APCI in Henan Provincial People's Hospital from January 2021 to December 2022 were divided into END group(n=75)and non-END group(n=241)according to the presence of END,and were compared the clinical data on admission such as NIHSS score,etiology classification and infarction site.The infarction area was assessed by posterior circulation Alberta stroke program early CT score(pc-ASPECTS)and the influencing factors of END were analyzed by multivariate logistic regression.The neurological status was assessed by modified Rankin scale(mRS)scores 14 d,1 month,and 3 months after onset.The proportion of good prognosis(mRS:0-2)was compared between two groups.Results(1)Among 316 patients with APCI,75 patients developed END(23.73％).The admission NIHSS score,admission pc-ASPECTS,and percentages of patients with large artery atherosclerosis,temporo-occipital infarction and cerebral pontic infarction were higher in END group[3.0(2.0,5.0),3.0(2.0,7.0),73.3％,12.0％,66.7％]than those in non-END group[2.0(1.0,3.0),2.0(1.5,8.0),40.7％,9.1％,47.7％](P＜0.05).(2)Large artery atherosclerosis(OR=1.375,95％CI:1.180-1.779,P=0.009),temporo-occipital infarction(OR=2.860,95％CI:1.011-8.092,P=0.048),pontic infarction(OR=2.860,95％CI:1.324-16.351,P=0.034),and admission NIHSS score(OR=1.245,95％CI:1.031-1.503,P=0.020)were the influencing factors of END in APCI patients.(3)The proportions of good prognosis were lower in END group 14 d,1 month and 3 months after onset(45.3％,57.3％,65.3％)than those in non-END group(79.7％,84.6％,91.3％)(P＜0.05).Conclusion APCI patients with large artery atherosclerosis,temporo-occiptal infarction,pontic infarction,and high admission NIHSS score are at a high risk of END,and APCI patients have poor prognosis after END.
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万方数据
维普
