Different Predictive Factors for Early Neurological Deterioration Based on the Location of Single Subcortical Infarction: Early Prognosis in Single Subcortical Infarction

Stroke ◽  
2021 ◽  
Author(s):  
Ki-Woong Nam ◽  
Hyung-Min Kwon ◽  
Yong-Seok Lee
Keyword(s):  
Odds Ratio ◽  
Pulsatility Index ◽  
Adjusted Odds Ratio ◽  
Neutrophil To Lymphocyte Ratio ◽  
Parent Artery ◽  
Nihss Score ◽  
Lymphocyte Ratio ◽  
Early Neurological Deterioration ◽  
Artery Disease ◽  
Subcortical Infarction

Background and Purpose: Patients with single subcortical infarctions (SSIs) have relatively a favorable prognosis, but they often experience early neurological deterioration (END). In this study, we compared the predictors for END in patients with SSI according to the location of the lesion. Methods: We included consecutive patients with SSIs within 72 hours of symptom onset presenting between 2010 and 2016. END was defined as an increase of ≥2 in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 in the motor NIHSS score within the first 72 hours of admission. Along with the analysis of all patients with SSI, we also analyzed the predictors for END in proximal/distal SSI patients and anterior/posterior circulation SSI patients. Results: A total of 438 patients with SSI were evaluated. In multivariable analysis, initial NIHSS score (adjusted odds ratio, 1.36 [95% CI, 1.15–1.60]), pulsatility index (adjusted odds ratio, 1.25 [95% CI, 1.03–1.52]), parent artery disease (adjusted odds ratio, 2.14 [95% CI, 1.06–4.33]), and neutrophil-to-lymphocyte ratio (adjusted odds ratio, 1.24 [95% CI, 1.04–1.49]) were positively associated with END. In patients with proximal SSI, initial NIHSS score, pulsatility index, parent artery disease, and neutrophil-to-lymphocyte ratio showed positive associations with END. Meanwhile, no variable related to END was found in the distal SSI group. When we compared the predictors for END based on the involved vascular territory, higher initial NIHSS score and neutrophil-to-lymphocyte ratio were significantly associated with END in patients with anterior circulation SSIs. On the contrary, higher pulsatility index values and the presence of parent artery disease were independent predictors for END in patients with SSIs in the posterior circulation. Conclusions: Initial NIHSS score, pulsatility index, parent artery disease, and neutrophil-to-lymphocyte ratio are associated with END in patients with SSIs. The frequency and predictors for END differ depending on the location of the SSI.

Abstract P665: Different Predictive Factors for Early Neurological Deterioration Based on the Location of Single Subcortical Infarction

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ki-woong Nam ◽  
Hyung-min Kwon ◽  
Yong-Seok Lee
Keyword(s):  
Multivariable Analysis ◽  
Posterior Circulation ◽  
Neurological Deterioration ◽  
Parent Artery ◽  
Anterior Circulation ◽  
Nihss Score ◽  
Early Neurological Deterioration ◽  
Artery Disease ◽  
Subcortical Infarction ◽  
Anterior Posterior

Introduction: Patients with single subcortical infarction (SSI) have relatively favorable prognosis, but they often experience early neurological deterioration (END) in a clinical course. In addition, SSI is considered to differ in its prognosis and mechanism depending on the location of the lesion. Hypothesis: We compared the predictors for END in patients with SSI according to the location of the lesion. Methods: We included consecutive patients with SSI within 72 hours of symptom onset between 2010 and 2016. END was defined as an increase of ≥ 2 in the total NIHSS score or ≥ 1 in the motor NIHSS score within the first 72 hours of admission. Along with the analysis of the entire SSI patients, we also analyzed the predictors for END in the proximal/distal SSI patients and the anterior/posterior circulation SSI patients. Results: A total of 438 patients with SSI were evaluated. In multivariable analysis, initial NIHSS score [adjusted odds ratio (aOR) = 1.36, 95% confidence interval (CI): 1.15-1.60], pulsatility index (PI) (aOR = 1.25, 95% CI: 1.03-1.52), parent artery disease (PAD) (aOR = 2.14, 95% CI: 1.06-4.33), and neutrophil to lymphocyte ratio (NLR) (aOR = 1.24, 95% CI: 1.04-1.49) were positively associated with END. In patients with proximal SSI, initial NIHSS score, PI, PAD, and NLR showed positive associations with END. Meanwhile, no variable related to END was found in distal SSI. When we compared the predictors for END based on the involved vascular territory, initial NIHSS score and NLR were significantly associated with END in the anterior circulation. On the other hand, patient with SSI in the posterior circulation showed PI and PAD as independent predictors of END. Conclusions: Initial NIHSS score, PI, PAD, and NLR were associated with END in patients with SSI. The frequency and predictors for END were different depending on the location of SSI lesion.

Triglyceride-glucose index is associated with early neurological deterioration in single subcortical infarction: Early prognosis in single subcortical infarctions

2021 ◽  
pp. 174749302098406
Author(s):  
Ki-Woong Nam ◽  
Min K Kang ◽  
Han-Yeong Jeong ◽  
Tae J Kim ◽  
Eung-Joon Lee ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Fasting Glucose ◽  
Close Association ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Neurological Deterioration ◽  
Nihss Score ◽  
Triglyceride Glucose Index ◽  
Early Neurological Deterioration ◽  
Subcortical Infarction

Background The research about the influence of triglyceride-glucose index on early prognosis in stroke is lacking. Aims In this study, we evaluated the association between triglyceride-glucose index and early neurological deterioration in patients with single subcortical infarctions. Methods Consecutive patients with single subcortical infarctions within 72 h of symptom onset between 2011 and 2015. Early neurological deterioration was defined as an increase of ≥2 in the total NIHSS score or ≥1 in the motor NIHSS score. The triglyceride-glucose index was calculated using the log scale of fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2. Results A total of 305 patients with single subcortical infarctions were evaluated. In multivariable analysis, the triglyceride-glucose index (adjusted odds ratio [aOR] = 2.94, 95% confidence interval [CI] = 1.58–5.45) and age (aOR = 1.05, 95% CI = 1.01–1.09) were associated with early neurological deterioration. In subgroup analysis according to the type of single subcortical infarctions, only patients with proximal single subcortical infarctions showed a significant association between the triglyceride-glucose index and early neurological deterioration (aOR = 2.92, 95% CI = 1.35–6.29). On the other hand, there was no statistical significance in patients with distal single subcortical infarctions. Patients with untreated diabetes also showed the close association between the triglyceride-glucose index and early neurological deterioration (aOR = 3.94, 95% CI = 1.47–10.52). Conclusions The triglyceride-glucose index was associated with early neurological deterioration in single subcortical infarctions. This association differed depending on the location of lesion and the presence of untreated diabetes.

scholarly journals Preoperative Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Mean Platelet Volume as Predictors of 1-Year Mortality in Patients Undergoing an Open Repair of Abdominal Aortic Aneurysms: A Retrospective Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5410
Author(s):  
Da Eun Ko ◽  
Hei Jin Yoon ◽  
Sang Beom Nam ◽  
Suk Won Song ◽  
Gisong Lee ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Subgroup Analysis ◽  
Mean Platelet Volume ◽  
Odds Ratio ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet Volume ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Survivor Group ◽  
Abdominal Aortic

Objectives: To investigate if preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), or mean platelet volume (MPV) could be used to predict 1-year mortality in patients undergoing open abdominal aortic aneurysm (AAA) repair. Methods: We retrospectively reviewed 382 patients who underwent open AAA repair between January 2008 and July 2019. We divided the patients into two groups based on 1-year mortality and compared the preoperative NLR, PLR, and MPV. The patients were then classified into tertiles based on their preoperative NLR (first tertile: < 2.41 (n = 111); second tertile: 2.41 ≤ NLR ≤6.07 (n = 111); and third tertile: > 6.07 (n = 112)). We compared the incidence of mortality and morbidity across the aforementioned tertiles. We performed a stepwise logistic regression analysis to evaluate the predictors for mortality. An additional subgroup analysis was performed by dividing the cases into non-ruptured and ruptured cases. Results: The preoperative NLR was significantly higher in the non-survivor group than in the survivor group (10.53 ± 7.60 vs. 5.76 ± 6.44, respectively, p = 0.003). The PLR and MPV were similar between the groups (145.35 ± 91.11 vs. 154.20 ± 113.19, p = 0.626, 9.38 ± 1.20 vs. 9.11 ± 1.39, p = 0.267, respectively). The incidence of 1-year mortality was 2.7%, 9.0%, and 14.3% in the first, second, and third NLR tertiles, respectively (p = 0.009). Higher NLR (odds ratio 1.085, 95% confidence interval 1.016–1.159, p = 0.015) and ruptured AAA (odds ratio 2.706, 95% confidence interval 1.097–6.673, p = 0.031) were the independent predictors of 1-year mortality in all patients. Moreover, the preoperative NLR was significantly higher in the ruptured AAA than in the non-ruptured AAA group (11.17 ± 7.90 vs. 4.10 ± 4.75, p < 0.001). In subgroup analysis, preoperative NLR (odds ratio 1.144, 95% confidence interval 1.031–1.271, p = 0.012) and PLR (odds ratio 0.986, 95% confidence interval 16 0.975–0.998, p = 0.017) was an independent predictor for 1-year mortality in ruptured cases. Conclusions: We demonstrated an independent relationship between the preoperative NLR and 1-year mortality in patients undergoing open AAA repair, besides PLR and MPV. Furthermore, the NLR and PLR had predictive power for 1-year mortality in ruptured cases.

scholarly journals Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease

2012 ◽  
Vol 20 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Hasan Kaya ◽  
Faruk Ertaş ◽  
Yahya İslamoğlu ◽  
Zekeriya Kaya ◽  
Zuhal Arıtürk Atılgan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Artery Disease
Sign in / Sign up

Export Citation Format

Share Document