Clinical predictors of stroke prognosis after endovascular therapy

Abstract

Abstract Background and Aims Endovascular therapy (EVT) has been shown to be effective in the treatment of large vascular occlusive stroke, but many factors are correlated with the outcome for acute ischemic stroke (AIS) patients after EVT[1]. There are so many factors such as baseline admitting NIHSS score, smoking, last known normal (LKN) time to puncture and so on impacted functional outcome of AIS[2]. This study aims to find the main factors that influence the poor prognosis of AIS patients after EVT by analyzing the clinical data of AIS patients. Methods We analyzed the clinical data of AIS patients in the First People’s Hospital of Xian Yang city in Sha’anXi province from June 2017 to August 2021 following treatment with EVT. The data included the patient blood pressure upon admission, blood glucose, National Institutes of Health Stroke Scale (NIHSS) score, and 90-day modified Rankin scale (mRs) score follow-up data, last known normal (LKN) time to puncture, LKN time to puncture was defined as the time from the patient's last normal time to the successful groin puncture (GP), calculated in minutes. A good outcome was defined as a 90-day mRs score of 0 to 3, and a poor outcome was defined as a 90-day mRs score of 4 to 6. Results A total of 144 patients were included in the study, baseline admitting NIHSS score, smoking, and LKN time to puncture, After NIHSS stratification, an NIHSS score of 6–12 was found to be relevant to the prognosis from the results of the univariate analysis. The baseline NIHSS were (odds ratio = 3.02; 95% confidence interval, 2.878–4.252; P < 0.001), LKN time to GP (odds ratio = 2.17; 95% confidence interval, 1.341–2.625; P < 0.01), and time stratification (6–12h) (odds ratio = 4.22; 95% confidence interval, 2.519–5.561; P < 0.001).The result showed higher baseline NIHSS, LKN time to puncture, and time were associated with poorer prognosis of stroke patients after EVT in a multivariate analysis. Conclusions Our study indicated that smoking, the baseline NIHSS score, and LKN time to puncture were the risk factors for a poor outcome of stroke patients following an EVT. Quitting smoking, shortening LKN time to puncture should improve the outcome of AIS after EVT.