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Predictors of failure of early neurological improvement in early time window following endovascular thrombectomy: a multi-center study

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资源类型：
Pubmed体系：
作者：
Lai Yuzheng[1] * ; Diana Francesco[2] ; Mofatteh Mohammad[3] ; Nguyen Thanh N[4] ; Jou Eric[5] ; Zhou Sijie[6] ; Sun Hao[1] ; He Jianfeng[1] ; Yan Wenshan[1] ; Chen Yiying[1] ; Feng Mingzhu[7] ; Chen Junbin[8] ; Ma Jicai[8] ; Li Xinyuan[9] ; Meng Heng[10] ; Abdalkader Mohamad[4] ; Chen Yimin[7,11] ;
机构： [1]Department of Neurology, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), Foshan, China. [2]Department of Neuroradiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy. [3]School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom. [4]Department of Radiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States. [5]School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom. [6]Department of Surgery of Cerebrovascular Diseases, First People's Hospital of Foshan, Foshan, China. [7]Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, Foshan, China. [8]Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, China. [9]The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. [10]Department of Neurology, The First Affiliated Hospital of Jinan University, Clinical Neuroscience Institute of Jinan University, Guangzhou, China. [11]Neuro International Collaboration (NIC), Foshan, China.
出处：
DOI： 10.3389/fneur.2023.1227825
ISSN：

关键词： early neurological improvement early time window endovascular therapy ischemic stroke patient outcome

摘要：
Endovascular thrombectomy (EVT) has become the gold standard in the treatment of acute stroke patients. However, not all patients respond well to this treatment despite successful attempts. In this study, we aimed to identify variables associated with the failure of improvements following EVT.We retrospectively analyzed prospectively collected data of 292 ischemic stroke patients with large vessel occlusion who underwent EVT at three academic stroke centers in China from January 2019 to February 2022. All patients were above 18 years old and had symptoms onset ≤6 h. A decrease of more than 4 points on the National Institute of Health Stroke Scale (NIHSS) after 24 h compared with admission or an NIHSS of 0 or 1 after 24 h was defined as early neurological improvement (ENI), whereas a lack of such improvement in the NIHSS was defined as a failure of early neurological improvement (FENI). A favorable outcome was defined as a modified Rankin scale (mRS) score of 0-2 after 90 days.A total of 183 patients were included in the final analyses, 126 of whom had FENI, while 57 had ENI. Favorable outcomes occurred in 80.7% of patients in the ENI group, in contrast to only 22.2% in the FENI group (p < 0.001). Mortality was 7.0% in the ENI group in comparison to 42.1% in the FENI group (p < 0.001). The multiple logistic regression model showed that diabetes mellitus [OR (95% CI), 2.985 (1.070-8.324), p = 0.037], pre-stroke mRS [OR (95% CI), 6.221 (1.421-27.248), p = 0.015], last known well to puncture time [OR (95% CI), 1.010 (1.003-1.016), p = 0.002], modified thrombolysis in cerebral infarction = 3 [OR (95% CI), 0.291 (0.122-0.692), p = 0.005], and number of mechanical thrombectomy passes [OR (95% CI), 1.582 (1.087-2.302), p = 0.017] were the predictors of FENI.Diabetes mellitus history, pre-stroke mRS, longer last known well-to-puncture time, lack of modified thrombolysis in cerebral infarction = 3, and the number of mechanical thrombectomy passes are the predictors of FENI. Future large-scale studies are required to validate these findings.Copyright © 2023 Lai, Diana, Mofatteh, Nguyen, Jou, Zhou, Sun, He, Yan, Chen, Feng, Chen, Ma, Li, Meng, Abdalkader and Chen.

基金：
The study was supported by the Foshan Science and Technology Bureau (Grant No. 2220001005022), the Medical Science and Technology Research Foundation of Guangdong Province (Grant No. 20221027164016611), Foshan the 14th Five-Year Plan Key Discipline Foundation, the Guangdong Provincial TCM Bureau Key Discipline Foundation, and the Foshan Brain Heart Co-Therapy Foundation. The Foshan 14th Five-Year Priority Speciality Construction Project, The Foshan Nanhai District 14th Five-Year Priority Speciality Construction Project, Foshan Traditional Chinese Medicine Immune Health Technology Innovation Base.
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2022]版：
大类 | 3 区 医学
小类 | 3 区 神经科学 3 区 临床神经病学
最新[2025]版：
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 神经科学
第一作者：
第一作者机构： [1]Department of Neurology, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), Foshan, China.
通讯作者：
通讯机构： [7]Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, Foshan, China. [11]Neuro International Collaboration (NIC), Foshan, China.
推荐引用方式(GB/T 7714)：
Lai Yuzheng,Diana Francesco,Mofatteh Mohammad,et al.Predictors of failure of early neurological improvement in early time window following endovascular thrombectomy: a multi-center study[J].Frontiers in neurology.2023,14:1227825.doi:10.3389/fneur.2023.1227825.
APA：
Lai Yuzheng,Diana Francesco,Mofatteh Mohammad,Nguyen Thanh N,Jou Eric...&Chen Yimin.(2023).Predictors of failure of early neurological improvement in early time window following endovascular thrombectomy: a multi-center study.Frontiers in neurology,14,
MLA：
Lai Yuzheng,et al."Predictors of failure of early neurological improvement in early time window following endovascular thrombectomy: a multi-center study".Frontiers in neurology 14.(2023):1227825

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