ABSTRACT
Objective To evaluate the value of stroke prognostication using age and National Institute of Health Stroke Scale index (SPAN) for outcome after early endovascular treatment for anterior circulation large vessel occlusion.Methods The patients who underwent early endovascular treatment were prospectively,sequentially collected in Yijishan Hospital of Wannan Medical College from December 2014 to September 2017 and Jinling Hospital from March 2014 to March 2017.Individuals whose age in years plus NIHSS score was greater than or equal to 100 were designated as SPAN-100-positive patients,while those with a score less than 100 were designated as SPAN-100-negative patients.We compared the baseline data and perioperative data between the two groups.The 90 days modified Rankin Scale score≤2 was regarded as favorable outcome.Single factor and multivariable Logistic regression analyses were used to determine the association between SPAN-100 and outcomes.Results One hundred and ninety patients were enrolled,20 (10.5％) of which were SPAN-100 positive,and 170(89.5％) were SPAN-100 negative.There were no significant differences between the two groups on postoperative intracerebral hemorrhage and 90 days mortality.Ninety days independence rates were higher in SPAN-100-negative patients (77/170,45.3％) than in SPAN-100 positive patients (4/20,20.0％;x2 =4.681,P =0.030).Multi-factor Logistic regression analysis showed that the higher preoperation systolic pressure (OR =1.030,95％ CI 1.008-1.052,P =0.007),the lower Alberta Stroke Program Early CT Score (OR =1.609,95％ CI 1.056-2.453,P =0.027) and poor collateral circulation(OR =5.714,95％ CI 1.668-19.570,P =0.006) were the independent risk factors of outcomes.Conclusion SPAN-100 is not an independent predictor of favorable outcome after adjusting for factors of outcomes in patients with anterior circulation large vessel occlusion.
ABSTRACT
Objeetive To investigate the relationship between the lesion sites and post-stroke depression (PSD) in patients with acute ischemic stroke.Methods From January 2015 to June 2016,patients with first-ever acute ischemic stroke admitted to the Department of Neurology,Wuhu Yijishan Hospital were enrolled prospectively.The demographic and baseline clinical data were recorded.The stroke lesions were localized by imaging and clinical symptoms within 24 h after admission.The patients were divided into PSD group (≥8) and non-PSD group (＜8) according to the Hamilton Depression Rating Scale score at l-month follow-up.Multivariate logistic regression analysis was used to investigate the independent correlation between PSD and lesion sites.Results A total of 376 patients with acute ischemie stroke were enrolled,including 177 females (47.07％) and 199 males (52.93％).Univariate analysis showed that there were significant differences in sex,years of education,hypertension,etiological classification of stroke (small vessel occlusion,cardiogenic embolism),baseline National Institutes of Health Stroke Scale (NIHSS) score,baseline Mini-Mental State Examination (MMSE) and left frontal lobe,left temporal lobe,and left basal ganglia lesions between the PSD group and the non-PSD group (all P ＜0.05).Multivariate logistic regression analysis showed that after adjusting for age,sex,years of education,hypertension,etiological classification of stroke,NIHSS score,and MMSE score,there was an independent correlation between the lesions in the left frontal lobe (odds ratio [OR] 1.838,95％ confidence interval [CI] 1.028-3.947;P =0.034),the left basal ganglia (OR 1.672,95％ CI 1.103-2.883;P=0.023),hypertension (OR 1.764,95％ CI 1.179-3.365;P =0.016) and PSD.Conclusions One month after the onset of ischemic stroke,there was a significant correlation between PSD and the lesion sites.Left frontal lobe lesion and left basal ganglia lesion were the independent predictors.