Multivariate analysis of the prognosis of mechanical thrombectomy in acuteischemic stroke with large vessel occlusion

doi:10.19854/j.cnki.1008-2425.2023.01.0008

Abstract

Abstract: Objective To evaluate the efficacy and safety of mechanical thrombectomy in the treatment of acute ischemic stroke (AIS),and to explore the factors affecting the clinical prognosis after mechanical thrombectomy.Methods A retrospective analysis was performed on 133 AIS patients who underwent mechanical thrombectomy in the Encephalopathy Center of the Second Affiliated Hospital of Bengbu Medical College from September 2019 to December 2021.The prognosis was determined by the modified Rankin Scale (mRS) score 90 days post operation.mRS score≤3 was defined as good prognosis,and mRS score>3 was defined as poor prognosis.Univariate and multivariate logistic regression analysis was used to explore the prognostic factors.Results Univariate analysis showed that compared with the poor prognosis group,the patients in the good prognosis group had lower preoperative NIHSS score,less thrombectomy times,fewer serious post-operative complications,and shorter hospital stay.Of course,good recanalization was the prerequisite for a good prognosis,and there were statistically significant differences between the two groups (P＜0.05).Multivariate logistic regression analysis showed that age,preoperative NIHSS scoreand severe postoperative complications were significantly correlated with the prognosis of patients (P＜0.05),which were independent factors affecting the prognosis of patients.Conclusion Preoperative NIHSS score and severe postoperative complications are important factors affecting the prognosis of AIS patients with large vessel occlusion after mechanical thrombectomy.

Key words: Stroke, Mechanical thrombectomy, Prognosis, Multivariate analysis

摘要： 目的评估机械取栓在治疗急性缺血性脑卒中(acute ischemic stroke,AIS)的有效性和安全性,探讨机械取栓术后影响临床预后的因素。方法回顾性分析蚌埠医学院第二附属医院脑病中心自2019年9月至2021年12月行机械取栓治疗的AIS患者133例,通过术后90d的改良Rankin量表(mRS)评分来确定预后,mRS评分≤3分定义为预后良好,将mRS＞3分定义为预后不良。采用单因素和多因素logistic回归分析探究影响患者预后的因素。结果单因素分析提示:与预后不良组相比,预后良好组患者术前NIHSS评分低,术中取栓次数少,术后严重并发症少,住院时间短,当然血管再通良好是患者预后良好的前提,两组患者上述资料有统计学差异(P＜0.05)。多因素logistic回归分析提示:年龄、术前NIHSS评分和术后严重并发症与患者预后显著相关(P＜0.05),为影响患者预后的独立因素。结论年龄、术前NIHSS评分、和术后严重并发症均是影响大血管闭塞性AIS患者机械取栓治疗预后的重要因素。

关键词: 脑卒中, 机械取栓, 预后, 多因素分析

CLC Number:

R743.31

Fan Shunzhi, Chen Zhe, Wang Dawei, et al. Multivariate analysis of the prognosis of mechanical thrombectomy in acuteischemic stroke with large vessel occlusion[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2023, 36(1): 42-47.

范顺志, 程哲, 王大巍, 张辉, 束汉生. 机械取栓治疗大血管闭塞急性缺血性脑卒中预后的多因素分析[J]. 立体定向和功能性神经外科杂志, 2023, 36(1): 42-47.

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