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Published on: February 5, 2011
Prognostic value of cerebral infarction coefficient in patients with massive cerebral infarction
Xiaoyan Du1, Qingjun Liu1, Qi Li2
1Department of Neurology, Yongchuan Hospital of Chongqing Medical University, 439 Xuanhua Road, Yongchuan District, Chongqing, China; Chongqing key laboratory of cerebrovascular disease research, 439 Xuanhua Road, Yongchuan District, Chongqing, China.
Insights
The cerebral infarction coefficient, a ratio of brain lesion volume to total brain volume, effectively predicts poor prognosis in patients with massive cerebral infarction (MCI). This new metric shows significant predictive value for patient outcomes.
Area of Science:
- Neurology
- Radiology
- Medical Prognostics
Background:
- Massive cerebral infarction (MCI) poses significant challenges in predicting patient outcomes.
- The need for reliable prognostic markers in MCI is critical for clinical decision-making.
Purpose of the Study:
- To introduce and evaluate the prognostic value of the cerebral infarction coefficient (CIC) in patients with MCI.
- To determine if CIC can serve as an independent predictor of poor prognosis in MCI.
Main Methods:
- A cohort of 71 patients with acute MCI was classified into good and poor prognosis groups based on the modified Rankin score.
- Clinical and imaging data were analyzed using univariate and binary logistic regression.
- The cerebral infarction coefficient was calculated as cerebral infarction volume divided by brain volume.
Main Results:
- Patients with poor prognosis exhibited significantly higher CIC, larger cerebral infarction volume, elevated D-dimer, older age, higher body temperature, and a different comorbidity profile (more atrial fibrillation, less hypertension).
- Binary logistic regression identified CIC as an independent risk factor for poor prognosis in MCI (OR=8.506, CI: 2.091-42.562).
- The CIC demonstrated a predictive sensitivity of 92.5% at a cutoff value of 7.8% (AUC=0.753).
Conclusions:
- The cerebral infarction coefficient is a valuable prognostic indicator for patients with massive cerebral infarction.
- CIC offers a quantifiable measure to predict the likelihood of a poor outcome in MCI patients.
- This coefficient may aid clinicians in tailoring treatment strategies and managing patient expectations.
Objective:
We proposed the concept of the cerebral infarction coefficient, which is cerebral infarction volume/brain volume. This study aimed to evaluate the prognostic value of the cerebral infarction coefficient in patients with massive cerebral infarction (MCI).
Methods:
According to the modified Rankin score, 71 patients with acute MCI were divided into good prognosis and poor prognosis groups. Clinical and imaging data of the two groups were collected and univariate analysis was carried out. If there were significant differences in the data between the two groups, binary logistic regression analysis was performed.
Results:
The poor prognosis group had a significantly higher cerebral infarction volume, cerebral infarction coefficient, and D-dimer levels, older age, the highest body temperature, a higher rate of a history of atrial fibrillation, and a lower rate of a history of hypertension compared with the good prognosis group (all P < 0.05). Binary logistic regression analysis showed that the cerebral infarction coefficient was an independent risk factor for a poor prognosis of patients with MCI (P < 0.05, 95 % confidence interval, 2.091, 42.562), and the odds ratio was 8.506. The area under the receiver operating characteristic curve for the cerebral infarction coefficient was 0.753. When the cut-off value was 7.8 %, the sensitivity of predicting a poor prognosis of patients with MCI was 92.5 %.
Conclusion:
The cerebral infarction coefficient may have predictive value in determining the prognosis of patients with MCI.
