Zhongguo quanke yixue (Apr 2024)
Predictive Value of Sarcopenia Index for Prognosis in Elderly Patients with Acute Ischemic Stroke
Abstract
Background Poor prognosis in elderly patients with acute ischemic stroke (AIS) has put great pressure on public health. Actively searching for simple and easy-to-operate clinical indicators to screen high-risk groups with poor prognosis has become a hot issue. Objective To analyze the predictive value of sarcopenia index (SI) on the prognosis of elderly patients with AIS. Methods A total of 280 elderly AIS patients hospitalized in Changzhou Jintan First People's Hospital from July 2021 to June 2022 were selected and divided into the poor prognosis group (≥3 points) and good prognosis group (≤2 points) according to the Modified Rankin Scale (mRS). Baseline data and National Institutes of Health Stroke Scale (NIHSS) scores at admission and discharge were compared between the two groups. Multivariate Logistic regression analysis was used to explore the factors affecting the prognosis of elderly patients with AIS, and a receiver operating characteristic (ROC) curve was plotted to analyze the value of SI in predicting poor prognosis in elderly patients with AIS. Results There were 212 cases in the good prognosis group and 68 cases in the poor prognosis group. There were significant differences in the history of diabetes and previous stroke, neutrophil count (NE), lymphocyte count (LY), albumin (ALB), admission NIHSS score, discharge NIHSS score, and SI between patients between the poor prognosis group and good prognosis group (P<0.05). Spearman rank correlation analysis results showed that SI was negatively correlated with the prognostic mRS score (rs=-0.195, P=0.001), admission NIHSS score (rs=-0.163, P=0.006), and discharge NIHSS score (rs=-0.205, P=0.001). The results of multivariate Logistic regression analysis showed that SI was an independent factor affecting the prognosis of elderly patients with AIS (OR=0.959, 95%CI=0.927-0.992, P=0.015). ROC curve analysis showed that the area under the ROC curve (AUC) for SI to predict poor prognosis in elderly AIS patients was 0.694 (95%CI=0.619-0.769), with a sensitivity of 69.3%, specificity of 64.7%, and cutoff value of 63.46; the enrolled patients were divided into Q1, Q2, Q3, and Q4 groups according to the quartiles of SI, with 70 cases in each group, there were significant differences in the age, history of AF and previous stroke, UA, Hcy, mRS score, admission NIHSS score, and discharge NIHSS score among the Q1, Q2, Q3, and Q4 groups (P<0.05) . Conclusion SI is significantly reduced in the poor prognosis group of elderly AIS patients. SI is an independent influencing factor for poor prognosis in elderly AIS patients with good predictive value.
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