Title:Risk Factors and Prognosis of Early Neurological Deterioration after
Bridging Therapy
Volume: 21
Issue: 1
Author(s): Yiju Xie, Shengyu Li, Liuyu Liu, Shiting Tang, Yayuan Liu, Shuangquan Tan and Zhijian Liang*
Affiliation:
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province,
China
Keywords:
Early neurological deterioration, acute ischemic stroke, bridging therapy, risk factors, prognosis, systolic blood pressure.
Abstract:
Background: Early neurological deterioration (END) after bridging therapy (BT) of
acute ischemic stroke (AIS) patients is associated with poor outcomes.
Objective: We aimed to study the incidence, risk factors and prognosis of END after BT.
Methods: From January to December 2021, the clinical data of AIS patients treated by BT (intravenous
thrombolysis with alteplase prior to mechanical thrombectomy) from three comprehensive
stroke centers were analyzed. Patients were divided into non-END group and END
group according to whether they developed END within 72 hours of symptom onset. Modified
Rankin scale (mRS) was used to assess the patient’s prognosis at 90 days, and favorable outcomes
were defined as mRS≤2. The incidence of END was investigated, and binary logistic regression
analysis was used to explore its associated factors.
Results: The incidence of END after BT was 33.67%. The eligible 90 patients included 29 cases
in the END group and 61 cases in the non-END group. Multivariate Logistic regression analysis
showed that increase of systolic blood pressure (SBP) (OR=1.026, 95%CI:1.001-1.051, p
=0.043), higher level of blood glucose at admission (OR=1.389, 95%CI:1.092-1.176, p =0.007)
and large artery atherosclerosis (LAA) subtype (OR=8.009, 95%CI:2.357-27.223, p =0.001)
were independent risk factors of END. Compared with the non-END group, the END group had
significantly lower rates of good outcomes (6.90% versus 65.57%, p =0.001) while higher rates
of mortality (44.83% versus 4.92%, p =0.001).
Conclusion: It was found that the incidence of END after BT in AIS patients was 33.67%. An
increase in SBP, higher glucose levels at admission, and LAA were independent risk factors of
END that predicted a poor prognosis.
