调查内血管治疗后中风患者和活跃癌症的出院预测因素
Yasaman Pirahanchi1, Constance McGraw2, Russell Bartt3
1Department of Neurology, Swedish Medical Center, Englewood, CO, USA.
Clinical neurology and neurosurgery
|March 28, 2025
概括
接受内血管治疗 (EVT) 的急性缺血性中风 (AIS) 患者患有活跃癌症的结果与没有癌症的患者相似. 美国国立卫生研究院中风量表 (NIHSS) 的入院评分预测了EVT治疗的癌症患者的良好结果.
科学领域:
- 神经学 神经学
- 在瘤学瘤学.
- 干预心脏病学 干预心脏病学
背景情况:
- 患有活跃癌症的急性缺血性中风 (AIS) 患者接受内血管治疗 (EVT),但结果预测因素尚不清楚.
- 关于癌症诊断是否影响AIS的EVT后的结果的数据有限.
研究的目的:
- 在接受EVT的AIS活跃癌症患者中确定有利出院结果 (修改的兰金尺度0-2) 的预测因素.
- 为了比较癌症和非癌症AIS患者与EVT治疗之间的结果.
主要方法:
- 对463名AIS患者 (≥18岁) 进行了回顾性队列研究,接受了EVT治疗 (07/2018-10/2020).
- 通过活跃癌症诊断分类的患者;用于识别有利结果的预测因素的多变量逻辑回归.
- 接收器操作特征 (ROC) 曲线分析评估了入院国家卫生研究院中风量表 (NIHSS) 的预测效用.
主要成果:
- 10%的EVT患者患有活跃的癌症,呈现出更高的高凝血率,先前的血块,功能衰竭和血栓塞栓事件.
- 在癌症 (24%) 和非癌症 (35%) 组 (p=0.13) 之间,有利的出院结果 (mRS 0-2) 并没有显著差异.
- 在癌症患者中,入院NIHSS独立预测了有利的结果 (AOR 0.81,p=0.01),最佳值为6 (AUC 0.88). 非癌症患者显示NIHSS (AOR 0.91,p<0.001),年龄和糖尿病史作为预测因素,NIHSS的最佳值为21 (AUC 0.77).
结论:
- 入院NIHSS是接受EVT的活跃癌症AIS患者出院结果的重要预测因素.
- 结合NIHSS和病史的风险分层可能会提高这些患者的结果预测.
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