Factors influencing early neurological improvement after mechanical thrombectomy among patients with acute basilar artery occlusion: a single center prospective observational cohort study.
机构：[1]Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, 119 South Fourth Ring West Road, Fengtai District, Beijing 100050, China首都医科大学附属天坛医院[2]Department of Neurology, Tong Ren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China
The predictive value of and the influencing factors associated with early neurological improvement (ENI) among patients with acute basilar artery occlusion (BAO) have not been well studied. The present study aimed to evaluate whether ENI predicted a better functional outcome and to identify the influencing factors of ENI. We performed a prospective observational analysis among 187 patients with acute BAO who underwent endovascular treatment (EVT) in Beijing Tiantan Hospital from January 2012 to July 2018. ENI was defined as having a drop on the National Institutes of Health Stroke Scale (NIHSS) by 8 or more scores or having a NIHSS of 0-1 within 24 h after EVT. A multivariate logistic regression model with backward selection was used to identify the influencing factors associated with ENI. ENI had a sensitivity of 0.69 and a specificity of 0.68 to predict a favorable outcome at 90 days after EVT. In addition, patients with ENIs had lower modified Rankin Scale score (mRS) (median: 2.0 vs. 5.0, p < 0.001) and were more likely to survive (95.2% vs. 72.0%, p < 0.001) and achieve functional independence (74.2% vs. 36.8%, p < 0.001). NIHSS before EVT, complete recanalization, white blood cell counts and general anesthetics were significant factors associated with ENI. A one-unit higher NIHSS and complete recanalization were associated with 1.04 (95% CI 1.01-1.08) and 2.71 (95% CI 1.14-6.45) times higher odds of achieving ENI, respectively. In conclusion, in patients with acute BAO, ENI within 24 hours after EVT can predict favorable outcomes at 90 day. Patients with higher NIHSS, lower white blood cell counts before surgery, without general anesthetics and patients with complete recanalization were more likely to achieve ENIs.
基金：
This work was supported by the National Key Research
and Development Program of China (2016YFC1301501) and
Beijing Municipal Science & Technology Commission (No.
Z18110000171837).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2019]版：
大类|3 区医学
小类|4 区心脏和心血管系统4 区血液学4 区外周血管病
最新[2025]版：
大类|3 区医学
小类|3 区血液学4 区心脏和心血管系统4 区外周血管病
第一作者：
第一作者机构：[1]Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, 119 South Fourth Ring West Road, Fengtai District, Beijing 100050, China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Sun Xuan,Zhang Huijun,Tong Xu,et al.Factors influencing early neurological improvement after mechanical thrombectomy among patients with acute basilar artery occlusion: a single center prospective observational cohort study.[J].Journal Of Thrombosis And Thrombolysis.2020,doi:10.1007/s11239-020-02153-0.
APA：
Sun Xuan,Zhang Huijun,Tong Xu,Gao Feng,Deng Yiming...&Miao Zhongrong.(2020).Factors influencing early neurological improvement after mechanical thrombectomy among patients with acute basilar artery occlusion: a single center prospective observational cohort study..Journal Of Thrombosis And Thrombolysis,,
MLA：
Sun Xuan,et al."Factors influencing early neurological improvement after mechanical thrombectomy among patients with acute basilar artery occlusion: a single center prospective observational cohort study.".Journal Of Thrombosis And Thrombolysis .(2020)
