序列CT ASPECTS的性能用于预测血栓化急性缺血性中风患者中风的结果
Sarawut Krongsut1, Wipasiri Naraphong2, Surachet Srikaew3
1Division of Neurology, Department of Internal Medicine, Saraburi Hospital, Saraburi, Thailand.
Journal of neurosciences in rural practice
|December 7, 2023
概括
序列方面,特别是在24小时和变化方面,显示在预测内出血 (ICH) 的准确性提高和 thrombolyzed急性缺血性中风患者的不良结果.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 脑卒中医学 脑卒中医学
背景情况:
- 急性缺血性中风 (AIS) 治疗涉及血栓溶解,但预测结果至关重要.
- 阿尔伯塔州中风计划的早期CT评分 (ASPECTS) 评估了早期的缺血变化.
- 连续的ASPECTS评估可能比基线评估提供更好的预测价值.
研究的目的:
- 为了比较连续ASPECTS (基线,24小时和变化) 的预测准确性,用于内出血 (IHM) 和血栓化AIS患者的不良结果.
- 为了确定24小时或变化的ASPECTS是否优于基线ASPECTS.
- 评价修改的兰金级别 (mRS) 评分在释放作为结果的衡量.
主要方法:
- 从萨拉布里医院 (2015-2022) 的345名血栓化AIS患者的回顾性分析.
- 接收机运行特征 (ROC) 曲线分析,以比较基线,24小时和变化方面曲线下的面积 (AuROC).
- 多变量逻辑回归用于调整潜在的混因素,并报告赔率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 24小时方面 (AuROC=0.955) 和变化方面 (AuROC=0.920) 显示出IHM的预测准确度高于基线方面 (AuROC=0.823).
- 对于不利的结局,24小时方面 (AuROC=0.853) 和变化方面 (AuROC=0.800) 也比基线方面 (AuROC=0.744) 更准确.
- 调整后的OR表明,24小时的ASPECTS和ASPECTS的变化显著预测了IHM和不利结果.
结论:
- 24小时的ASPECTS和ASPECTS的变化是内出血和AIS血栓化患者不良结果的更精确的预测指标.
- 连续的ASPECTS评估提供了超出基线评估的有价值的预后信息.
- 这些发现支持在管理血栓化AIS患者时使用串行ASPECTS.
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