Predictors of rapid neurological improvement after mechanical thrombectomy in acute anterior circulation isch-emic stroke
Objective To investigate the factors influencing rapid neurological improvement(RNI)after mechani-cal thrombectomy(MT)in patients with acute anterior circulation ischemic stroke(AACIS),and to construct a predictive scoring model for RNI.Methods A retrospective study was conducted on 312 AAIS patients treated with MT at the South-west Hospital and the Zigong Third People's Hospital from January 2017 to October 2021.Univariate analysis and multi-variate logistic regression analysis were performed to identify the independent factors influencing RNI.A scoring model for RNI prediction was established by assigning scores to significant variables in multivariate analysis.The prediction value was evalu-ated using the receiver operating characteristic(ROC)curve.Results Among the 312 AACIS patients,159(50.96%)dem-onstrated RNI.Multivariate logistic regression analysis showed that history of diabetes mellitus[odds ratio(OR)=0.518;95%confidence interval(CI)0.290-0.926;P=0.027]and Van Swieten score(3-4 points)(OR=0.537;95%CI 0.294-0.981;P=0.043)were independent risk factors for RNI in AACIS patients after MT.However,mTICI(grade 2b or 3)was an inde-pendent protective factor for RNI in patients with AACIS(OR=3.912;95%CI 1.706-8.982;P=0.001).The area under the ROC curve of the predictive scoring model was 0.628(95%CI 0.565-0.690;P<0.001).The optimal cut-off value was 3 points,the sensitivity was 68.39%,and the specificity was 52.98%.Conclusion The predictive scoring model consisting of history of diabetes mellitus,preoperative Van Swieten score,and postoperative mTICI grade is valuable in predicting RNI in patients with AACIS after MT.
Acute anterior circulation ischemic strokeMechanical thrombectomyRapid neurological im-provementPredictive scoring model
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