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Objective:To investigate the correlation and predictive value of fibrinogen-to-albumin ratio (FAR) and clinical outcomes after intravenous thrombolysis in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke received intravenous thrombolysis treatment at Fuyang People's Hospital from November 2019 to August 2022 were retrospectively included. Their clinical, imaging, and laboratory data were collected. After 3 months of onset, a modified Rankin Scale was used for clinical outcome evaluation and a score >2 were defined as poor outcome. Multivariate logistic regression analysis was used to determine the correlation between FAR and poor outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of FAR on adverse outcomes after intravenous thrombolysis in patients with acute ischemic stroke. Results:A total of 162 patients were included. There were 114 patients (70.4%) in the good outcome group and 48 (29.6%) in the poor outcome group. Univariate analysis showed that the baseline National Institutes of Health Stroke Scale (NIHSS) score, fasting blood glucose, fibrinogen, and FAR in the poor outcome group were significantly higher than those in the good outcome group, while the serum albumin was significantly lower than that of the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that the baseline NIHSS score (odds ratio [ OR] 1.176, 95% confidence interval [ CI] 1.082-1.227; P<0.001), fasting blood glucose ( OR 1.206, 95% CI 1.018-1.430; P=0.030), and FAR ( OR 1.448, 95% CI 1.449-1.824; P=0.002) were the independent risk factors for poor outcome. The ROC curve analysis showed that the area under the curve of FAR for predicting poor outcomes was 0.706 (95% CI 0.616-0.796). When the FAR cutoff value was 8.06, the sensitivity and specificity were 66.7% and 78.2%, respectively. Conclusion:There is a significant correlation between FAR and outcomes after intravenous thrombolysis therapy in patients with acute ischemic stroke. Higher FAR has certain predictive value for poor outcomes of patients.
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Objective:To investigate the correlation between eosinophil count and short-term outcomes of patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke treated in Fuyang People's Hospital from June 2017 to June 2019 were enrolled retrospectively. The demographic and baseline clinical data were collected. The modified Rankin Scale was used to evaluate the short-term clinical outcome at the time of discharge or 14 d after onset. 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of poor short-term outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of eosinophil count for poor short-term outcome. Results:A total of 300 patients with acute ischemic stroke were enrolled, including 187 males (62.3%) and 113 females (37.7%); their age was 63.62±12.14 years; baseline National Institutes of Health Stroke Scale (NIHSS) score was 5.48±4.85. Two hundred and twenty-eight patients (76.0%) had a good outcome and 72 (24.0%) had a poor outcome. Univariate analysis showed that age, hypertension, baseline NIHSS score, C-reactive protein, atrial fibrillation, and neutrophil count of the poor outcome group were significantly higher than those of the good outcome group, while male, smoking, eosinophil count and percentage of eosinophils were significantly lower than those of the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that baseline NIHSS score (odds ratio [ OR] 1.726, 95% confidence interval [ CI] 1.400-2.128; P<0.001), hypertension ( OR 3.744, 95% CI 1.227-11.426; P=0.020) and eosinophil count ( OR 0.287, 95% CI 0.102-0.616; P=0.043) were the independent influencing factors for the poor short-term outcome. ROC curve analysis showed that the area under the curve of eosinophil count for predicting the poor short-term outcome was 0.717 (95% CI 0.642-0.792), the best cutoff value was 0.075×10 9/L, and its sensitivity and specificity for predicting the poor short-term outcome were 88.6% and 51.4% respectively. Conclusion:The decreased eosinophil count had a certain predictive value for the poor short-term clinical outcome of patients with acute ischemic stroke.
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Stroke has become one of the main causes of death in China, and ischemic stroke is the most common type. At the same time, the prevalence of chronic kidney disease (CKD) is also increasing, and there are many similar risk factors with ischemic stroke. More and more studies have shown that CKD increases the incidence, severity and risk of poor outcome of ischemic stroke, but the specific mechanism of its interaction is not completely clear. For ischemic stroke patients with CKD, the most effective treatment and prevention measures are lack of sufficient evidence. This article reviews the relationship between CKD and ischemic stroke, as well as the treatment and prevention.
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Objective To investigate the correlation between serum alkaline phosphatase (ALP) level and early functional outcomes in young patients with acute ischemic stroke. Methods From January 2017 to December 2018, consecutive young patients (18-45 years old) with acute ischemic stroke admitted to the Department of Neurology, Fuyang People's Hospital were enrolled. According to the modified Rankin Scale score at discharge or on the 14th day of hospitalization (whichever occurs first), the patients were divided into poor outcome group ( > 2) and good outcome group (0-2). Multivariate logistic regression analysis was used to determine the independent correlation between the serum ALP level and outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of baseline serum ALP level for poor outcomes. Results A total of 200 young patients with acute ischemic stroke were enrolled, and 138 (69. 0％) in the good outcome group and 62 (31. 0％) in the poor outcome group. Univariate analysis showed that the serum ALP level (87. 72 ±25. 60 U/L vs. 81. 70 ±22. 95 U/L; t = -4. 464, P < 0. 001) and baseline National Institutes of Health Stroke Scale (NIHSS) score (median and interquartile range: 9 [8- 12] vs. 2 [1-4]; Z = -10. 540, P < 0. 001) in the poor outcome group were significantly higher than those in the good outcome group. Multivariate logistic regression analysis showed that high serum ALP levels (odds ratio 1. 030, 95％ confidence interval 1. 001-1. 060; P = 0. 040) and high baseline NIHSS score (odds ratio 2. 387, 95％ confidence interval 1. 799-3. 142; P < 0. 001) were the independent risk factors for early poor outcomes. ROC curve analysis showed that the optimal cut-off value of the baseline serum ALP level predicting poor outcome was 86. 25 U/L, and its sensitivity and specificity were 53. 2％ and 79. 7％, respectively. Conclusions High serum ALP level is independently associated with poor early outcomes in young patients with acute ischemic stroke. Baseline serum ALP level has certain predictive value for poor outcomes.
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Wake-up stroke accounts for about 25％ of all new ischemic stroke.Many patients with wake-up stroke can not receive thrombolytic therapy because the uncertainty of onset time.Recent studies have shown that the multimodal imaging may screen suitable patients with wake-up stroke for early thrombolysis treatment.