医学
溶栓
内科学
优势比
置信区间
心脏病学
冲程(发动机)
逻辑回归
心房颤动
脑梗塞
脑出血
心肌梗塞
缺血
蛛网膜下腔出血
机械工程
工程类
作者
Mengzhi Jin,Qingxia Peng,Yidong Wang
出处
期刊:Heliyon
[Elsevier]
日期:2023-04-22
卷期号:9 (5): e15620-e15620
被引量:9
标识
DOI:10.1016/j.heliyon.2023.e15620
摘要
Early neurological deterioration (END) after ischemic stroke is a severe clinical event and can be caused by hemorrhagic and ischemic injury. We studied the difference between the risk factors of END occurs with or without hemorrhagic transformation after intravenous thrombolysis.Consecutive cerebral infarction patients who underwent intravenous thrombolysis from 2017 to 2020 in our hospital were retrospectively recruited. END was defined as a ≥2 points increase on 24-h National Institutes of Health Stroke Scale (NIHSS) score after therapy compared with the best neurological status after thrombolysis and divided into two types based on the computed tomography (CT): symptomatic intracranial hemorrhage (ENDh) and non-hemorrhagic factors (ENDn). Potential risk factors of ENDh and ENDn were assessed by multiple logistic regression and applied to establish the prediction model.A total of 195 patients were included. In multivariate analysis, the previous history of cerebral infarction (odds ratio [OR],15.19; 95% confidence interval [CI],1.43-161.17; P = 0.025), previous history of atrial fibrillation (OR,8.43; 95%CI,1.09-65.44; P = 0.043), higher baseline NIHSS score (OR,1.19; 95%CI,1.03-1.39; P = 0.022) and higher alanine transferase level (OR,1.05; 95%CI, 1.01-1.10; P = 0.016) were independently associated with ENDh. While higher systolic blood pressure (OR,1.03; 95%CI,1.01-1.05; P = 0.004), higher baseline NIHSS score (OR,1.13; 95%CI,2.86-27.43; P < 0.000) and large artery occlusion (OR,8.85, 95%CI,2.86-27.43; P < 0.000) were independent risk factors of ENDn. The prediction model showed good specificity and sensitivity in predicting the risk of ENDn.There are differences between the major contributors to ENDh and ENDn, while a severe stroke can increase the occurrence of both sides.
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