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BMC Neurology
Published in: BMC Neurology 1/2023

Open Access 01-12-2023 | Stroke | Research

Risk factors for early neurologic deterioration in single small subcortical infarction without carrier artery stenosis: predictors at the early stage

Authors: Di Jin, Jing Yang, Hui Zhu, Yuexia Wu, Haichao Liu, Qi Wang, Xiaoyun Zhang, Yanhua Dong, Bin Luo, Yong Shan, Lvming Zhang, Peifu Wang, Jichen Du

Published in: BMC Neurology | Issue 1/2023

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Abstract

Objectives

This study aimed to assess the epidemiological features and explore the potential risk factors for early neurological deterioration (END) in patients with acute single small subcortical infarction (SSSI) who underwent antiplatelet therapy without carotid artery stenosis.

Materials & methods

Patients with SSSI, as confirmed by cranial magnetic resonance imaging (MRI), who were hospitalized within 48 h after the onset of symptoms were enrolled. END was mainly defined as increment in the National Institutes of Health Stroke Scale (NIHSS) score of ≥ 2 points or any new neurological deficit. Poor functional outcome was defined as modified Rankin Scale (mRS) score of > 2 points at 3-month after the onset. The association of END with multiple indicators was assessed at the early stage of admission using multivariate logistic regression analysis, and adjusted odds ratios (aORs) were calculated.

Results

A total of 280 patients were enrolled from June 2020 to May 2021, of whom, END occurred in 44 (15.7%) patients (median age, 64 years; 70.5% male), while END occurred during sleep in 28 (63.6%) patients. History of hypertension (aOR: 4.82, p = 0.001), infarction in internal capsule (aOR: 3.35, p = 0.001), and elevated level of low-density lipoprotein cholesterol (LDL-C; aOR: 0.036, p = 0.0016) were significantly associated with the risk of END. Patients with END (aOR: 5.74, p = 0.002), history of diabetes (aOR: 2.61, p = 0.020), and higher NIHSS scores at discharge (per 1-score increase, aOR: 1.29, p = 0.026) were associated with the poor functional outcome at 3-month after the onset.

Conclusion

Patients with a history of hypertension, infarction in internal capsule or a higher level of LDL-C were found to be at a higher risk of END.
Appendix
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Metadata
Title
Risk factors for early neurologic deterioration in single small subcortical infarction without carrier artery stenosis: predictors at the early stage
Authors
Di Jin
Jing Yang
Hui Zhu
Yuexia Wu
Haichao Liu
Qi Wang
Xiaoyun Zhang
Yanhua Dong
Bin Luo
Yong Shan
Lvming Zhang
Peifu Wang
Jichen Du
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Neurology / Issue 1/2023
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-023-03128-3

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