预测内血管血栓切除术后中风患者的大型病变后的徒劳性再通道化:SNAP评分
Hidetoshi Matsukawa1,2, Huanwen Chen3,4, Sameh Samir Elawady1
1Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Neurosurgery
|October 29, 2024
概括
SNAP评分有效预测大血管封闭 (LVO) 卒中患者的徒劳重管 (FR) 低阿尔伯塔中风计划早期计算机断层扫描评分 (ASPECTS) 接受内血管血栓切除术 (EVT). 这种工具有助于为患者,家人和临床医生制定关于结果的现实期望.
科学领域:
- 神经学 神经学
- 干预性放射学 干预性放射学
- 脑卒中医学 脑卒中医学
背景情况:
- 低ASPECTS (<6) 的大血管封闭性 (LVO) 卒中对内血管血栓切除术 (EVT) 结果构成挑战.
- 虚空再通道 (FR) 被定义为尽管再输血成功,但功能结果不佳,是这些患者的一个重大问题.
研究的目的:
- 开发和验证在接受EVT的LVO和低ASPECTS患者中FR的预测得分.
- 确定FR的独立预测因子,以创建一个用户友好的临床评分.
主要方法:
- 对219名前部循环LVO和低ASPECTS患者的回顾性分析,这些患者接受了成功的EVT.
- 多变量后勤回归以确定FR预测因子,然后构建和验证SNAP得分.
- 接收器操作特征 (ROC) 曲线分析,以评估SNAP得分的预测性能.
主要成果:
- 开发了SNAP评分,包括闭塞部位,NIH中风量表,年龄和中风前的mRS.
- 在训练 (AUC 0.79) 和验证 (AUC 0.79) 队列中,SNAP得分显示出良好的预测准确性.
- 一个SNAP得分≥5表示一个高的积极预测值 (92.1%) 的FR.
结论:
- 在LVO患者中,SNAP评分是预测LVO患者在EVT后具有低ASPECT的FR的宝贵工具.
- 这一分数可以帮助管理患者,家庭和医疗保健提供者对急性缺血性中风与大心脏病发作的结果的期望.
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