AN ANALYSIS OF INFLUENCING FACTORS FOR SHORT-TERM PROGNOSIS AFTER ENDOVASCULAR TREATMENT IN ELDERLY PATIENTS WITH POSTERIOR CIRCULATION INFARCTION

Abstract

Objective To explore the influencing factors for short-term prognosis after endovascular treatment in elderly patients with posterior circulation infarction (POCI). Methods A retrospective analysis was performed on the clinical data of 50 elderly patients with POCI who received endovascular treatment in the Nuclear Industry 416 Hospital from January 2019 to December 2020. The clinical data included patients’ preoperative general status (age, sex, smoking history, and alcohol abuse history), past disease history (diabetes, hypertension, hyperuricemia, and transient ischemic attack), post-onset indicators [onset-to-door time (ODT), door-to-needle time (DNT), NIH Stroke Scale (NIHSS) on admission], and postoperative conditions (immediate postoperative NIHSS, revascularization, and postoperative complications). The patients were divided into good prognosis group and poor prognosis group according to modified Rankin Scale (mRS) score 90 d after endovascular treatment and were analyzed for the differences in the above indicators. Meanwhile, a multivariate logistic regression analysis was performed on the influencing factors for patients’ short-term prognosis after endovascular treatment. Results There were 20 and 30 patients in the good prognosis group and poor prognosis group, respectively, demonstrating significant differences between the two groups in nine indicators [systolic blood pressure, glycosylated hemoglobin (HbA1c), serum uric acid, total cholesterol, postoperative modified Thrombolysis in Cerebral Infarction (mTICI) grade, preoperative NIHSS score, immediate postoperative NIHSS score, ODT, and postoperative stroke-related pneumonia] (t=2.30-4.13,χ2=6.35,7.07,P<0.05). The multivariate logistic regression analysis showed that HbA1c ≥6.5%, serum uric acid ≥420 mmol/L (male) or 360 mmol/L (female), postoperative mTICI grade (blood vessel obstruction), and immediate postoperative NIHSS score ≥10 were risk factors for patients’ short-term prognosis after endovascular treatment (P<0.05). Conclusion HbA1c, serum uric acid, postoperative mTICI grade, and immediate postoperative NIHSS score are possible influencing factors for short-term prognosis after endovascular treatment in patients with POCI. It is important to enhance postoperative assessments of the above indicators and to receive active treatment for optimal outcomes.

Keywords

• brain infarction|endovascular procedures|prognosis|root cause analysis|logistic models