Prediction of the Lethal Outcome of Acute Recurrent Cerebral Ischemic Hemispheric Stroke
| Autor: | Anton Kuznietsov, Liubov Novikova, Olexandr Kozyolkin |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Hemispheric stroke Neurological examination Article NLR septum pellucidum Cohort Studies Neuroimaging Recurrence Risk Factors Internal medicine medicine Humans Prospective Studies Stroke Septum pellucidum Aged Aged 80 and over Nihss score lcsh:R5-920 Receiver operating characteristic medicine.diagnostic_test Stroke scale business.industry General Medicine Middle Aged medicine.disease Survival Analysis glycemia Logistic Models recurrent ischemic stroke outcome prognosis National Institutes of Health Stroke Scale (NIHSS) ROC Curve Area Under Curve Anesthesia Female lcsh:Medicine (General) business |
| Zdroj: | Medicina; Volume 55; Issue 6; Pages: 311 Medicina Volume 55 Issue 6 Medicina, Vol 55, Iss 6, p 311 (2019) |
| ISSN: | 1648-9144 |
| DOI: | 10.3390/medicina55060311 |
| Popis: | Background and objectives. Stroke-induced mortality is the third most common cause of death in developed countries. Intense interest has focused on the recurrent ischemic stroke, which rate makes up 30% during first 5 years after first-ever stroke. This work aims to develop criteria for the prediction of acute recurrent cerebral ischemic hemispheric stroke (RCIHS) outcome on the basis of comprehensive baseline clinical, laboratory, and neuroimaging examinations. Materials and Methods. One hundred thirty-six patients (71 males and 65 females, median age 74 (65 78)) with acute RCIHS were enrolled in the study. All patients underwent a detailed clinical and neurological examination using National Institutes of Health Stroke Scale (NIHSS), computed tomography of the brain, hematological, and biochemical investigations. In order to detect the dependent and independent risk factors of the lethal outcome of the acute period of RCIHS, univariable and multivariable regression analysis were conducted. A receiver operating characteristic (ROC) analysis with the calculation of sensitivity and specificity was performed to determine the prediction variables. Results. Twenty-five patients died. The independent predictors of the lethal outcome of acute RCIHS were: Baseline NIHSS score (OR 95% CІ 1.33 (1.08&ndash 1.64), p = 0.0003), septum pellucidum displacement (OR 95% CI 1.53 (1.17&ndash 2.00), p = 0.0021), glucose serum level (OR 95% CI 1.28 (1.09&ndash 1.50), p = 0.0022), neutrophil-to-lymphocyte ratio (OR 95% CI 1.11 (1.00&ndash 1.21), p = 0.0303). The mathematical model, which included these variables was developed and it could determine the prognosis of lethal outcome of the acute RCIHS with an accuracy of 86.8% (AUC = 0.88 ± 0.04 (0.88&ndash 0.93), p < 0.0001). |
| Databáze: | OpenAIRE |
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