急性虚血性脳卒中患者に対する血管内血栓回収療法の予後予測：多施設共同後ろ向き研究

Acute ischemic stroke (AIS) is a leading cause of mortality and long-term disability worldwide. The identification of reliable prognostic determinants and formation of a validated model for AIS is unclear. We retrospectively recruited 210 patients with stroke of anterior circulation large-vessel occlusion who underwent endovascular thrombectomy between March 2021 and March 2024. Participants were aged 18 years or older and had undergone examination and treatment for at least 90 days. We collected baseline demographic characteristics, medical records, and blood biomarkers and tracked the prognosis for 30 days. We used LASSO-logistic regression to identify potential indicators of AIS over a 90 days. After adjusting for age (P = .130), previous stroke or transient ischemic attack (P = .112), admission diastolic pressure (P = .101), glucose (P = .162), and albumin (P = .094), only male (vs female, P = .042), alcohol consumption (P = .013), hypertension (P = .007), trial of acute stroke treatment type "others" versus large artery atherosclerosis, P = .046), leukocytes (P = .013), and neutrophil-to-lymphocyte ratio (P < .001) remained significant predictors of poor clinical endpoints. The prognostic model had a classification accuracy of 77.6%, a sensitivity of 79.3%, a specificity of 73.3%, and a precision of 88.1%. This study identified modifiable risk factors such as alcohol consumption and hypertension, along with inflammatory markers such as leukocyte count and neutrophil-to-lymphocyte ratio, as significant predictors of poor outcomes in patients with AIS undergoing endovascular thrombectomy. These findings could guide clinicians in identifying high-risk patients and in tailoring treatment strategies. Further studies are needed to validate these predictors and to explore their potential roles in therapeutic interventions.