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作者

Zhixia Li, Jiheng Hao, Changming Wen, Tao Cheng, Yanxin Zhao, Xuesong Bai, Xiaofan Guo, Wenbo Cao, Tianhua Li, Xiao-Li Min, Liqun Jiao, Liyong Zhang, Bin Yang

作者单位

Affiliations ¹ Department of Neurology, Qilu Hosipital of ShanDong University Dezhou Hosipital, Dezhou, China. ² Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. ³ Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, Shandong, China. ⁴ Department of Neurology, Nanyang Central Hospital, Nanyang, China. ⁵ Department of Neurosurgery, The Affiliated Cardiovascular Hospital of Shanxi Medical University and Shanxi Cardiovascular Hospital (Institute), Taiyuan, China. ⁶ Department of Neurology, Jinan Hospital of Xuanwu Hospital, Shandong First Medical University, Jinan, China. ⁷ China International Neuroscience Institute (China-INI), Beijing, China. ⁸ University of Pittsburgh Medical Center Stroke Institute, Department of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. ⁹ Department of Neurosurgery, Jinan University Affiliated Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China. ¹⁰ Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Kunming Medical University, Kunming, China. ¹¹ Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China. ¹² Department of Neurosurgerynt, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical University, National Center for Neurological Disorders, Beijing, China. ¹³ Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China yangbin_81@16 com.

刊名

BMJ open

年份

2025

卷号

Vol.15 No.10

页码

e101244

ISSN

2044-6055

关键词

NEUROSURGERY Prognosis Stroke.

摘要

Objective: This study aims to investigate the predictors of very poor outcomes in patients with acute ischaemic stroke due to large vessel occlusion after successful endovascular thrombectomy. Design: A multicentre, retrospective study. Setting: Data were derived from tertiary care facilities in five cities of China. Participants: This study included 1242 patients with anterior circulation large-vessel occlusion who underwent endovascular thrombectomy, and they were stratified by 90-day modified...更多

Objective: This study aims to investigate the predictors of very poor outcomes in patients with acute ischaemic stroke due to large vessel occlusion after successful endovascular thrombectomy. Design: A multicentre, retrospective study. Setting: Data were derived from tertiary care facilities in five cities of China. Participants: This study included 1242 patients with anterior circulation large-vessel occlusion who underwent endovascular thrombectomy, and they were stratified by 90-day modified Rankin Scale scores into a very poor outcome group and a non-very poor outcome group . Primary outcome measures: The primary outcome was very poor outcomes. Data from 1242 patients were analysed for demographic, laboratory, imaging and perioperative data. Results: Among the 1242 recruited patients, 318 exhibited very poor outcomes. In multivariate analysis, predictors of very poor outcomes were higher age , stroke history , coronary heart disease history,higher baseline National Institute of Health Stroke Scale , higher neutrophil count , lower Alberta Stroke Program Early CT Score , higher malignant cerebral oedema and symptomatic intracranial haemorrhage and receiving intravenous thrombolysis . The predictive model demonstrated a certain degree of accuracy . Conclusions: The very poor outcomes were associated with advanced age, CHD history, stroke history, high NIHSS score, high neutrophil count, low ASPECTS and presence of MCE and sICH, while receiving intravenous thrombolysis was a protective factor. These poor outcome predictors might play a crucial role in informing clinical decision-making. Trial registration number: ClinicalTrials.gov ; pre-results.收起

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