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首页> 外文期刊>Brain and Behavior >Clinical characteristics and risk score for poor clinical outcome of acute ischemic stroke patients treated with intravenous thrombolysis therapy
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Clinical characteristics and risk score for poor clinical outcome of acute ischemic stroke patients treated with intravenous thrombolysis therapy

机译：静脉溶栓治疗急性缺血性中风患者临床预后不良的临床特征和风险评分

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Background Tissue plasminogen activator (t‐PA) is an effective therapy for acute ischemic stroke, but some patients still have poor clinical outcome. In this study, we investigated clinical characteristics of stroke patients and determined predictors for poor clinical outcome in response to t‐PA treatment. Methods Clinical data from 247 patients were retrospectively reviewed. Clinical parameters that were associated with survival of patients were analyzed. Areas under receiver operating characteristic curves (ROC) were used to determine the feasibility of using various combinations of the clinical parameters to predict poor clinical response. The clinical outcome was defined according to the changes in Modified Rankin Scale. Results Overall, 145 patients had improved/complete recovery, 73 had no change, and 29 had worsening conditions or died during the in‐clinic period. A univariate analysis showed that baseline characteristics including age, CRP, blood glucose level, systolic blood pressure, and admission NIHSS were significantly different ( p?? 0.05) among patients with different clinical outcome. A further multivariate analysis was then performed. Variables associated with poor clinical outcome (worsening/death) ( p ??0.1) were included in the logistic regression model. Four parameters were retained in the model: Age, CRP, Blood glucose level, and Systolic blood pressure (ACBS). To allow a convenient usage of the ACBS classifier, the parameters were put into a scoring system, and the score at 7.7 was chosen as a cut‐off. The ROC curve of this ACBS classifier has an area under the curve (AUC) of 0.7788, higher than other individual parameters. The ACBS classifier provided enhanced sensitivity of 69.2% and specificity of 74.3%. Conclusion The ACBS classifier provided a satisfactory power in estimating the patients’ clinical outcome. After further validating, the classifier may provide important information to clinicians for making clinical decisions.
机译：背景组织纤溶酶原激活剂（t-PA）是治疗急性缺血性中风的有效方法，但有些患者的临床结局仍然较差。在这项研究中，我们调查了中风患者的临床特征，并确定了对t-PA治疗反应不良的临床预后指标。方法回顾性分析247例患者的临床资料。分析了与患者生存相关的临床参数。接收器工作特征曲线（ROC）下的面积用于确定使用各种临床参数组合预测不良临床反应的可行性。根据改良兰金量表的变化定义临床结局。结果总体上，有145例病情好转/完全康复，其中73例病情无变化，其中29例病情恶化或在临床期间死亡。单因素分析表明，在不同临床结局的患者中，基线特征包括年龄，CRP，血糖水平，收缩压和入院NIHSS有显着差异（p <0.05）。然后进行进一步的多元分析。与不良临床结果（恶化/死亡）相关的变量（p <0.1）包括在逻辑回归模型中。模型中保留了四个参数：年龄，CRP，血糖水平和收缩压（ACBS）。为了方便使用ACBS分类器，将参数放入评分系统，并选择7.7作为总分。此ACBS分类器的ROC曲线的曲线下面积（AUC）为0.7788，高于其他各个参数。 ACBS分类器提供了69.2％的增强灵敏度和74.3％的特异性。结论ACBS分类器为评估患者的临床疗效提供了令人满意的动力。在进一步验证之后，分类器可以向临床医生提供重要信息以做出临床决策。

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