Essen Score Combined With Skull And Neck 3D-TOF-MRA For Predict The Risk Of Cerebral Infarction Recurrence Within 1 Year

Objective: Essen stroke risk score is widely used to predict the risk of cerebral infarction recurrence,but it may not have sufficient predictive efficacy.The significant stenosis of the large vessels in the skull and neck is significantly correlated with the recurrence of cerebral infarction,and both the sensitivity and specificity of3D-TOF-MRA in the detection of obvious stenosis of the large vessels in the head and neck is high.In this study,based on the Essen score,we proposed a modified Essen score which adds the factor of obvious stenosis of the head and neck vessels indicated by 3D-TOF-MRA.The modified Essen score was used to predict the risk of recurrence within 1 year after cerebral infarction,in order to provide more effective secondary prevention for patients prone to relapses.Methods: A total of 750 patients with cerebral infarction were included in this study and divided into two groups according to the recurrence and non-recurrence within a year.The risk factors in the Essen score and the significant stenosis of the skull and neck vessels indicated by 3D-TOF-MRA were analyzed by logistic univariate analysis,and the risk factors associated with the recurrence of cerebral infarction were screened for logistic multivariate analysis.According to the ? value of the factor of obvious stenosis of the head and neck large vessels,a certain score was given to this factor,and a modified Essen score was constructed by combining this factor with the factors selected from the original score.The two scores were used to score the patients,then compare the predictive effects of the two scores on the recurrence of cerebral infarction,and use the ROC curve to compare the predictive ability of the two scores.Results: A total of 57 patients(7.6%)relapsed.Age,hypertension,diabetes mellitus,history of myocardial infarction,smoking,history of cerebral infarction were screened from the Essen score,these factors and the significant stenosis of the large vessels in the skull and neck indicated by 3D-TOF-MRA are independent risk factors for cerebral infarction recurrence(P < 0.05).Combining these factors to construct a modified score,statistical analysis of recurrence rate indicated that compared with theoriginal score,the improved score was positively correlated with the recurrence rate.The modified score(AUC=0.85)had better predictive ability than the original score(AUC=0.75).Conclusion: The modified Essen score based on Essen score and combined with head and neck 3D-TOF-MRA is better than the original score to predict the recurrence of cerebral infarction within 1 year.Besides,the score of the modified Essen score was positively correlated with the recurrence rate,and the patients with high scores should be reinforced with secondary prevention.