Nomogram to Predict Poor Outcome after Mechanical Thrombectomy at Older Age and Histological Analysis of Thrombus Composition.
Nomogram to Predict Poor Outcome after Mechanical Thrombectomy at Older Age and Histological Analysis of Thrombus Composition.
复制标题
预测老年机械血栓切除术后不良结果的列线图和血栓成分的组织学分析
DOI：
10.1155/2020/8823283
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发表时间：
2020
影响因子：
--
通讯作者：
Zhao Y
中科院分区：
文献类型：
--
作者：
Meng L;Wang H;Yang H;Zhang X;Zhang Q;Dong Q;Shu Z;Chen L;Gong L;Zhao Y
目前还没有一个简单的评分系统来预测老年人机械血栓切除术后不良结局的风险。因此，我们的目的是建立一个诺模图，预测老年急性缺血性卒中患者接受血栓切除术后的不良预后概率。此外，我们试图研究组织学血栓成分与卒中特征之间的相关性。为此，我们使用从2015年11月至2019年12月从卒中中心收集的数据前瞻性研究了一个发达队列。主要结局是功能独立性，定义为机械血栓切除术后90天时改良兰金量表评分≤ 2。一个诺模图模型的基础上，多变量逻辑模型。回收的血栓用苏木精和伊红染色，并根据组织学组成进行评估。我们的研究结果表明，年龄≥ 72岁与不良结局独立相关。共有304名参与者完成了随访数据，以生成诺模图模型。多变量logistic回归分析后，5个变量仍然是预后的独立预测因素，包括年龄、出血性转化、脑梗死溶栓评分、国立卫生研究院卒中评分和嗜中性粒细胞/淋巴细胞比率，并用于生成列线图。模型的受试者工作特征曲线下面积为0.803。与年轻患者相比，患有大动脉粥样硬化、前循环和成功再通组的老年受试者的凝块中纤维蛋白的百分比更高。这是第一个在卒中中心队列中开发和验证的列线图，用于个性化预测机械血栓切除术后老年患者的不良结局。血凝块的组成提供了有价值的信息，在老年患者的氧化的潜在发病机制。
An easy scoring system to predict the risk of poor outcome after mechanical thrombectomy among the elderly is currently not available. Therefore, we aimed to develop a nomogram for predicting the probability of negative prognosis in aged patients with acute ischemic stroke undergoing thrombectomy. In addition, we sought to investigate the association between histological thrombus composition and stroke characteristics. To this end, we prospectively studied a developed cohort using data collected from a stroke center from November 2015 to December 2019. The main outcome was functional independence, defined as a modified Rankin Scale score ≤ 2 at 90 days following a mechanical thrombectomy. A nomogram model based on multivariate logistic models was generated. The retrieved thrombi were stained with hematoxylin and eosin and assessed according to histological composition. Our results demonstrated that age ≥ 72 years was independently associated with poor outcome. A total of 304 participants completed the follow-up data to generate the nomogram model. After multivariate logistic regression, five variables remained independent predictors of outcome, including older age, hemorrhagic transformation, thrombolysis in cerebral infarction score, National Institute of Health Stroke score, and neutrophil-to-lymphocyte ratio, and were used to generate the nomogram. The area under the receiver-operating characteristic curve of the model was 0.803. The clots from elderly subjects with large-artery atherosclerosis, anterior circulation, and successful recanalization groups had a higher percentage of fibrin compared to those of younger patients. This is the first nomogram to be developed and validated in a stroke center cohort for individualized prediction of poor outcome in elderly patients after mechanical thrombectomy. Clot composition provides valuable information on the underlying pathogenesis of oxidation in older patients.
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DOI：
10.1097/mbc.0000000000000602
发表时间：
2017-07
期刊：
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
影响因子：
--
作者：
Helms CC;Kapadia S;Gilmore AC;Lu Z;Basu S;Kim-Shapiro DB
通讯作者：
Kim-Shapiro DB
影响因子：
6
作者：
Compter, Annette;van der Hoeven, Erik J. R. J.;Schonewille, Wouter J.
通讯作者：
Schonewille, Wouter J.
影响因子：
8.3
作者：
Tiedt, Steffen;Herzberg, Moriz;Wollenweber, Frank A.
通讯作者：
Wollenweber, Frank A.
缺血再灌注损伤中的自由基损伤：血运重建治疗后急性缺血性中风的一个障碍
影响因子：
--
作者：
Sun MS;Jin H;Sun X;Huang S;Zhang FL;Guo ZN;Yang Y
通讯作者：
Yang Y
影响因子：
4.8
作者：
Alawieh, Ali;Starke, Robert M.;Spiotta, Alejandro M.
通讯作者：
Spiotta, Alejandro M.