The Risk Factors And Prognosis With Early Neurological Deterioration In Acute Cerebral Infarction Patients

Objectives To investigate the risk factors correlated with early neurological deterioration(END)in acute cerebral infarction(ACI)patients and the relationship between the risk factors and the clinical outcome of the patients.Methods Patients with ACI admitted to the department of neurology of our hospital within 24 hours were consecutively enrolled.The patients were divided into END group and no-END group based on an increase of 2 or more points of the National Institutes of Health Stroke Scale(NIHSS)within 72 hours after admission.The various demographic and clinical data between the two groups were compared.The patients with END were also divided into either good outcome group or poor outcome group according to the modified Rankin scale(m RS)scores evaluated at 30 days after onset.Multivariate logistic regression analysis was performed to determine the independent risk factors of predicting the poor outcome.Results A total of 647 acute CI patients were enrolled.Among them,212(32.77%)patients suffered END in the initial 72 hours after admission.Compared to the no-END group,the END group exhibited a higher level of basal line NIHSS,homocysteine,serum creatinine,total bilirubin and fibrinogen(Fib).Multivariate logistic regression analysis shows that the basal line NIHSS,homocysteine(Hcy)and level of serum fibrinogen are the independent risk factors of END.Among 212 END cases,126(59.43%)patients had poor outcomes at the 30 day after onset,which are much higher than that of the no-END patients(29.66%).The poor outcome END patients had elder age,higher basal line NIHSS,higher level of serum total bilirubin,direct bilirubin and fibrinogen than those of the good outcome patients.Logistic regression analysis shows that basal line NIHSS and age are the independent risk factors of prognosis of CI patients with END.Conclusion It is common that CI patients may suffer END after onset.The basal line NIHSS and serum level of total bilirubin,Hcy and Fib are the predictors of END.The basal line NIHSS and age are the independent risk factors of prognosis for CI patients withEND.