Analysis of related risk factors of neurological deterioration in patients with acute cerebral infarction / 中国脑血管病杂志

ABSTRACT

Objective Toinvestigatetherelatedriskfactorsofneurologicaldeterioration(ND)in patientswithacutecerebralinfarction.Methods Atotalof446patientswithacutecerebral infarction admitted to the Department of Neurology,Zhongda Hospital,Southeast University from January 2012 to December 2013 were analyzed retrospectively. ND was defined as the reevaluation of the National Institutes of Health Stroke Scale (NIHSS)scores at any time for the increased admission baseline score 2 (ND2)or 4 (ND4)within the first 72 hours. All subjects were divided into a ND2 group (n=107)and a non-ND2 group (n=339)or a ND4 group (n=62)and a non-ND4 group (n=384 ). The differences of general demography,vascular risk factors,imaging,and hematological dataamongthedifferentgroupswerecompared.Results Ofthe446patients,107cases(24.0%) were diagnosed as ND2 and 62 cases (13. 9%)were diagnosed as ND4. The result of univariate analysis showed that there were significant differences in the length of hospital stay,age,baseline NIHSS score,baseline systolic blood pressure on admission,guilty artery occlusion,and the levels of leukocyte,fasting glucose,and C-reactive protein between the ND2 patients and the non-ND2 patients (all P<0. 05). There were significant differences in sex,age,atrial fibrillation,baseline NIHSS score, baseline systolic blood pressure on admission,guilty artery occlusion,and the level of C-reactive protein between the ND4 patients and the non-ND4 patients (all P<0. 05). After adjustment for the confounding factors,the results of Logistic regression analysis showed that the baseline NIHSS score (OR,1.114, 95%CI 1. 0481-1.185,P=0. 001),C-reactive protein (OR,1. 014,95%CI 1. 004-1. 024,P=0. 004), and guilty artery occlusion (OR,2. 303,95%CI 1. 152-4. 606,P=0. 018)were independently correlated with ND2;while the age (OR,1. 040,95%CI 1. 011-1. 070,P=0. 006),systolic blood pressure (OR, 1.015,95%CI 1. 003-1. 027,P=0. 018),C-reactive protein (OR,1. 016,95%CI 1. 005-1. 026,P=0.003),and guilty artery occlusion (OR,2. 845,95%CI 1. 291-2. 269,P =0. 009)were independently correlatedwithND4.Conclusion TheearlyonsetofNDinpatientswithacutecerebralinfarctionare closely associated with age,stroke severity,baseline systolic blood pressure,C-reactive protein,and occlusion of guilty artery. In the clinical diagnosis and treatment,detecting the above indicators timely may contribute to identify the patients with acute cerebral infarction and early progressive deterioration.