Analysis of risk factors of poor prognosis after recanalization treatment of anterior and posterior circulation tandem lesions

Abstract

Objective To analyze the prognosis and risk factors of the anterior and posterior circulation tandem lesions (TLs) patients after recanalization treatment. Methods The general and clinical data of 42 patients with TLs who received recanalization treatment in Shijiazhuang People's Hospital from April 2019 to August 2022 were retrospectively collected. The prognosis of 90 d after surgery was evaluated by the modified Rankin Scale (mRS). Univariate and multivariate stepwise Logistic regression analyses were used to investigated the risk factors of poor prognosis of TLs. Results According to mRS scores at the 90 d after surgery, the patients were divided into good prognosis group (mRS ≤ 2, n = 21) and poor prognosis group (mRS > 2, n = 21). The National Institutes of Health Stroke Scale (NIHSS) score at admission (Z = ⁃ 2.916, P = 0.004), time from onset to recanalization (Z = ⁃ 2.048, P = 0.041), mechanical thrombectomy times ≥ 3 (χ2 = 4.725, P = 0.030) and the proportion of hematoma type hemorrhagic transformation (χ2 = 8.400, P = 0.004) in the poor prognosis group were higher than those in good prognosis group. Logistic regression analysis showed that high NIHSS score at admission (OR = 12.457, 95%CI: 2.066-75.120; P = 0.006), mechanical thrombectomy times ≥ 3 (OR = 9.387, 95%CI: 1.222-72.140; P = 0.031) and postoperative hemorrhagic transformation (OR = 7.237, 95%CI: 1.019-51.403; P = 0.048) wererisk factors of poor prognosis of TLs. Conclusions Anterior and posterior circulation TLs patients with lower NHISS score at admission, mechanical thrombectomy times < 3 and without postoperative hemorrhagic transformation may have good prognosis.

Keywords

• ischemic stroke; tandem lesions (not in mesh); recanalization treatment (not in mesh); prognosis; risk factors; logistic models