Analysis Of Factors Affecting The Progression Of Acute Mild Ischemic Stroke In Senile Patients

Objective: To analyze the related factors affecting the progress of Acute mild ischemic stroke(AMIS)in the acute phase in elderly patients,so as to guide clinicians to carry out clinical intervention as early as possible and improve the prognosis.Methods:Elderly patients(aged 60 years and over)diagnosed with AMIS admitted to the Department of Neurology ward of our hospital from January 2019 to August 2022 were retrospectively analyzed,and the related factors affecting the disease progression in the acute phase of elderly AMIS patients were analyzed.According to the national institutes of health stroke scale(NIHSS),elderly AMIS patients with NIHSS≤5 at admission were enrolled,and their disease progressed during hospitalization(within 6 hours to 1 week after acute stroke onset;Patients with progressive neurological impairment and an increase in NHISS score of ≥2 points)were included in the progressive group,otherwise,they were included in the non-progressive group.Through the self-made data extraction table,the basic information,imaging(MRI)data and NIHSS score of the included patients were collected and statistically analyzed.Results: A total of 357 elderly patients with AMIS were enrolled in this study,including 239 males and 118 females,with an average age of 68.81 years.The incidence of disease progression was 32.49%,with 116 cases in the progression group and 241 cases in the non-progression group.The basic data of the two groups were compared,including age,NIHSS score,m RS Score,history of hypertension,history of type 2 diabetes,history of coronary heart disease,history of atrial fibrillation,and the differences were statistically significant(all P<0.05).There were significant differences in fasting blood glucose,glycosylated hemoglobin,and D-dimer between the two groups(P<0.05).Binary logistic regression analysis showed that the m RS Score at admission was associated with the early progression of AMIS(OR=1.464,95%CI:1.041-2.059,P=0.029).The higher the m RS Score at admission,the greater the risk of the progression of AMIS.Type 2 diabetes was associated with early progression of AMIS(OR=2.513,95%CI:1.033-6.114,P=0.042).The risk of progression in AMIS patients with a history of type 2 diabetes was 2.513 times higher than that in patients without a history of type 2 diabetes.A history of CHD was associated with the early progression of AMIS(OR=2.881,95%CI:1.138-7.295,P=0.026).The risk of disease progression in the acute phase of AMIS in elderly patients with a history of CHD was 2.881 times higher than that in patients without a history of CHD.The level of D-dimer at admission was associated with the early progression of AMIS(OR=1.006,95%CI:1.003-1.009,P<0.001).The higher the level of D-dimer at admission,the greater the risk of progression of AMIS.The area under the ROC curve of D-dimer at admission was the largest,which was superior to other indicators in predicting the prognosis of AMIS.Conclusion:Higher m RS Score,higher D-dimer level,type 2 diabetes mellitus and coronary heart disease are risk factors for early neurological deterioration in elderly patients with AMIS.