Predictors of early clinical deterioration after acute ischemic stroke
Predictors of early clinical deterioration after acute ischemic stroke
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DOI：
10.1016/j.ajem.2009.12.019
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发表时间：
2011-07-01
影响因子：
3.6
通讯作者：
Fann, W. C.
中科院分区：
文献类型：
--
作者：
Lin, Leng C.;Yang, J. T.;Fann, W. C.
预测中风患者早期病情恶化的方法是有争议的。我们研究了实验室测量和先前确定的危险因素，以确定中风后早期恶化的因素或预测因素。对196例首次急性缺血性脑卒中患者进行了前瞻性观察研究。记录了人口统计数据、患者病史、实验室测量和最初的中风严重程度评估。美国国立卫生研究院卒中量表评分早期恶化（3天内增加>= 3分）的患者被定义为进化性卒中（SIE）。30例患者被诊断为SIE。美国国立卫生研究院卒中量表初始评分为12或更高，格拉斯哥昏迷量表评分为12或更低，d -二聚体超过1000，或血尿素氮/肌酐（BUN/Cr）比高于15在SIE患者中更常见。多因素分析后，只有BUN/Cr高于15是SIE的独立预测因子。这些患者发生SIE的可能性高出3.41倍（P = 0.008）。这些发现表明BUN/Cr可能是一种新的SIE预测指标，在急诊科可能有用。(C) 2011爱思唯尔公司版权所有。
The measurements for predicting early deterioration of stroke patients is controversial. We studied laboratory measurements and previously identified risk factors to identify factors or predictors of early deterioration after stroke. A prospective observational study of 196 patients with first-time acute ischemic stroke was performed. Demographic data, patient histories, laboratory measurements, and initial stroke severity assessments were recorded. Patients with early deterioration in National Institutes of Health Stroke Scale scores (increase >= 3 points within 3 days) were defined as having stroke-in-evolution (SIE). Thirty patients were diagnosed with SIE. An initial National Institutes of Health Stroke Scale score of 12 or higher, a Glasgow Coma Scale score of 12 or lower, D-dimers more than 1000, or blood urea nitrogen/creatinine (BUN/Cr) ratio higher than 15 were more frequent in SIE patients. After multivariate analysis, only a BUN/Cr higher than 15 was independent predictor of SIE. These patients were 3.41-fold more likely to have SIE (P = .008). These findings suggest that BUN/Cr may be a novel predictor of SIE, potentially useful in emergency departments. (C) 2011 Elsevier Inc. All rights reserved.