Abstract：
BACKGROUND: Mechanical thrombectomy (MT) is usually recommended for acute ischemic stroke (AIS) due to large vessel occlusion (LVO) within the time window (6 hours after the disease onset). However, poor prognosis in acute great vascular occlusive stroke after MT, which is not an uncommon occurrence, can be attributed to an absence of appropriate postoperative monitoring. Transcranial Doppler (TCD) ultrasound and quantitative electroencephalography (QEEG) offer the advantages of fast, convenient, and bedside examinations compared with conventional imaging techniques.
OBJECTIVE: We aimed to analyze the predictive performance of clinical factors, Transcranial Doppler (TCD) ultrasound and quantitative electroencephalography (QEEG) for the prognosis of patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) at 90 days after discharge.
METHODS: Patients achieved revascularization through MT performed within 6 hours after the onset of AIS due to LVO were included. We use the data to build four predictive models of prognosis and compared the predictive performance measured by the area under the curve, sensitivity, and specificity.
RESULTS: A total of 74 patients were included in the study. Among them, 47 patients had a poor prognosis (63.5%) on discharge, and 45 patients had a poor prognosis (60.8%) at 90 days after discharge. Independent predictors of poor prognosis at 90 days after discharge were identified as follows: age, NIHSS score on admission, PI on the affected/healthy side, and RAP. Among the four models built, AUC was the highest (reaching 0.831) when age was combined with NIHSS score on admission, TCD parameters (VD on the affected side, PI on the affected/healthy side), and QEEG parameter (RAP) for prognostic prediction. However, AUC of the four predictive models did not differ significantly (P>0.05).
CONCLUSIONS: Age, NIHSS score on admission, TCD parameters, and QEEG parameter were independent predictors of the prognosis at 90 days after discharge in patients receiving MT for AIS due to LVO in the anterior circulation. The model combining the above four parameters may be helpful for prognostic prediction in such patients.
OBJECTIVE: We aimed to analyze the predictive performance of clinical factors, Transcranial Doppler (TCD) ultrasound and quantitative electroencephalography (QEEG) for the prognosis of patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) at 90 days after discharge.
METHODS: Patients achieved revascularization through MT performed within 6 hours after the onset of AIS due to LVO were included. We use the data to build four predictive models of prognosis and compared the predictive performance measured by the area under the curve, sensitivity, and specificity.
RESULTS: A total of 74 patients were included in the study. Among them, 47 patients had a poor prognosis (63.5%) on discharge, and 45 patients had a poor prognosis (60.8%) at 90 days after discharge. Independent predictors of poor prognosis at 90 days after discharge were identified as follows: age, NIHSS score on admission, PI on the affected/healthy side, and RAP. Among the four models built, AUC was the highest (reaching 0.831) when age was combined with NIHSS score on admission, TCD parameters (VD on the affected side, PI on the affected/healthy side), and QEEG parameter (RAP) for prognostic prediction. However, AUC of the four predictive models did not differ significantly (P>0.05).
CONCLUSIONS: Age, NIHSS score on admission, TCD parameters, and QEEG parameter were independent predictors of the prognosis at 90 days after discharge in patients receiving MT for AIS due to LVO in the anterior circulation. The model combining the above four parameters may be helpful for prognostic prediction in such patients.
摘要：
背景：由于大血管闭塞（LVO）在时间窗内（疾病发作后6小时），通常建议对急性缺血性卒中（AIS）进行机械血栓切除术（MT）。然而,MT后急性大血管闭塞性卒中预后不良，这并不罕见，可归因于缺乏适当的术后监测。经颅多普勒(TCD)超声和定量脑电图(QEEG)具有快速、方便,和床边检查与常规成像技术相比。
目的：我们旨在分析临床因素的预测性能，经颅多普勒(TCD)超声和定量脑电图(QEEG)对出院后90天大血管闭塞(LVO)所致急性缺血性卒中(AIS)患者预后的影响。
方法：患者在因LVO引起的AIS发作后6小时内通过MT实现血运重建。我们使用数据建立了四种预后预测模型，并比较了曲线下面积测量的预测性能，灵敏度,和特异性。
结果：本研究共纳入74例患者。其中,47例患者出院时预后不良（63.5%），45例患者在出院后90天预后不良（60.8%）。出院后90天预后不良的独立预测因素如下：年龄，NIHSS录取时得分,受影响/健康方面的PI，RAP。在建造的四个模型中，当年龄与入院时NIHSS评分相结合时，AUC最高（达到0.831），TCD参数(受影响侧的VD,受影响/健康侧的PI)，和QEEG参数（RAP）预测预后。然而,4种预测模型的AUC差异无统计学意义(P>0.05)。
结论：年龄，NIHSS录取时得分,TCD参数,和QEEG参数是由于前循环LVO而接受MT治疗的AIS患者出院后90天预后的独立预测因子。结合上述四个参数的模型可能有助于此类患者的预后预测。
目的：我们旨在分析临床因素的预测性能，经颅多普勒(TCD)超声和定量脑电图(QEEG)对出院后90天大血管闭塞(LVO)所致急性缺血性卒中(AIS)患者预后的影响。
方法：患者在因LVO引起的AIS发作后6小时内通过MT实现血运重建。我们使用数据建立了四种预后预测模型，并比较了曲线下面积测量的预测性能，灵敏度,和特异性。
结果：本研究共纳入74例患者。其中,47例患者出院时预后不良（63.5%），45例患者在出院后90天预后不良（60.8%）。出院后90天预后不良的独立预测因素如下：年龄，NIHSS录取时得分,受影响/健康方面的PI，RAP。在建造的四个模型中，当年龄与入院时NIHSS评分相结合时，AUC最高（达到0.831），TCD参数(受影响侧的VD,受影响/健康侧的PI)，和QEEG参数（RAP）预测预后。然而,4种预测模型的AUC差异无统计学意义(P>0.05)。
结论：年龄，NIHSS录取时得分,TCD参数,和QEEG参数是由于前循环LVO而接受MT治疗的AIS患者出院后90天预后的独立预测因子。结合上述四个参数的模型可能有助于此类患者的预后预测。
