METHODS: This study recruited patients with acute BAO who received endovascular therapy (EVT) at two stroke centers in China. PSH Assessment Measure ≥8 was included in the PSH+ group, while those with a score below 8 were classified as the PSH- group. Clinical data and radiological findings were compared between the two groups. A binary logistic regression model was employed to identify independent risk factors for PSH.
RESULTS: 101 participants were enrolled, of whom 19 (18.8%) presented with PSH as the initial manifestation of BAO. Worse prognosis (modified Rankin Scale score of 4-6) at day 90 occurred in 14 (73.7%) of the PSH+ patients and 42 (51.2%) of the PSH- patients (P=0.076). The 90-day mortality rate was higher in the PSH+ group with 12 (63.2%) participants, compared with 31 (37.8%) participants in the PSH- group (P=0.044). A significantly increased risk of PSH was found in patients with midbrain involvement (OR 6.53, 95% CI 1.56 to 27.30, P=0.01) and a high baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.15, 95% CI 1.01 to 1.31, P=0.037).
CONCLUSIONS: Patients with BAO presenting with PSH as the initial clinical manifestation experience a higher risk of 90-day mortality, despite undergoing EVT. Midbrain infarction and baseline NIHSS score may be significant risk factors for PSH following BAO.
方法:本研究招募了在中国两个卒中中心接受血管内治疗(EVT)的急性BAO患者。PSH+组包括PSH评估措施≥8,而那些得分低于8分的被归类为PSH-组。比较两组的临床资料和影像学检查结果。采用二元Logistic回归模型确定PSH的独立危险因素。
结果:101名参与者被登记,其中19人(18.8%)以PSH为BAO的初始表现。在第90天,不良预后(改良的Rankin量表评分为4-6)发生在14例(73.7%)PSH患者和42例(51.2%)PSH患者中(P=0.076)。PSH+组的90天死亡率更高,有12名(63.2%)参与者,与PSH组31名(37.8%)参与者相比(P=0.044)。在中脑受累(OR6.53,95%CI1.56至27.30,P=0.01)和高基线美国国立卫生研究院卒中量表(NIHSS)评分(OR1.15,95%CI1.01至1.31,P=0.037)的患者中,PSH的风险显着增加。
结论:以PSH为初始临床表现的BAO患者90天死亡的风险更高,尽管接受了EVT。中脑梗死和基线NIHSS评分可能是BAO后PSH的重要危险因素。