The Value Of Buffer Coefficient In Predicting Malignant Middle Cerebral Artery Infarction

Objective : To evaluate the value of buffer coefficient(cerebral infarction volume/ buffer volume)in predicting malignant middle cerebral artery infarction.Methods:A retrospective analysis was performed on 131 patients with internal carotid or middle cerebral artery infarction who were hospitalized in the department of neurology of Yongchuan Hospital Affiliated to Chongqing Medical University from January 2017 to August2020.During the course of the disease,the secondary consciousness disturbance because of cerebral edema(the level of consciousness≥2 point on the NIHSS)、the anisocoria or death attributed to herniation were malignant infarction.According to whether they had progressed to a malignant course,they were divided into malignant group(53 cases)and non-malignant group(78 cases).The clinical and imaging data of the two groups were statistically analyzed,the receiver-operator characteristics(ROC)curve was used to evaluate the prediction effect,and the Youden index was used to determine the optimal cut-off value.Results:There were no significant differences in clinical data,cranial cavity volume and parenchymal volume between the two groups(P>0.05).The cerebral infarct volume and buffer coefficient in malignant group were larger than those in non-malignant group,the buffer volume in malignant group were smaller than those in non-malignant group,the differences were statistically significant(P<0.05).Cerebral infarct volume(OR=1.023)and buffer coefficient(OR=20.463)were risk factors for malignant infarction,while buffer volume(0R=0.981)was a protective factor.Cerebral infarct volume,buffer volume and buffer coefficient can all predict the occurrence of malignant middle cerebral artery infarction,among which the area under the ROC curve of buffer coefficient was the largest,which was 0.965.When the buffer coefficient was 2.25,the sensitivity and specificity in predicting malignant infarction were 87% and95%.Conclusions:The buffer coefficient can predict the occurrence of malignant middle cerebral artery infarction better than the cerebral infarction volume or buffer volume alone,which has certain reference value for the judgment of the disease condition and the choice of treatment plan for patients with middle cerebral artery infarction.