Predictive factors of early neurological deterioration in patients with single subcortical infarction / 国际脑血管病杂志

ABSTRACT

Objective:To investigate the predictive factors of early neurological deterioration (END) in patients with single subcortical infarction (SSI).Methods:Consecutive patients with SSI within 12 h of onset admitted to the Department of Neurology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2016 to December 2021 were included retrospectively. The clinical and imaging data of the END and non-END groups were collected and compared. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Results:A total of 1 060 patients with SSI were included, of which 268 (25.28%) developed END. There were statistically significant differences in the infarct involving internal capsule on diffusion-weighted imaging, SSI classification, maximum diameter and classification of the infarcts, and the number of infarct layers between the END group and the non-END group (all P<0.05). Multivariate logistic regression analysis showed that the infarct involved the internal capsule (odds ratio [ OR] 1.52, 95% confidence interval [ CI] 1.27-1.96; P=0.015), the maximum diameter of the infarct ( OR 1.33, 95% CI 1.12-1.42; P=0.023), proximal SSI ( OR 1.49, 95% CI 1.28-1.92; P=0.018), and the number of infarct layers (compared to 1 layer, 3 layers: OR 15.01, 95% CI 4.12-12.45, P=0.013; ≥ 4 layers: OR 15.42, 95% CI 5.67-18.43, P=0.004) were independent risk factors for END. Conclusion:Infarct involved internal capsule on diffusion-weighted imaging, larger diameter of the infarct, proximal SSI, and ≥3 layers of infarct may be predictive factors of the occurrence of END in patients with SSI.