The Relationship Between Nutritional Status And Clinical Prognosis In Patients With Acute Anterior Circulation Large Vessel Occlusive Stroke After Endovascular Treatment

Objective: To explore the effect of nutritional status on the 90 d functional prognosis of patients with acute anterior circulation large vessel occlusive stroke(ALVOS)treated with endovascular treatment(EVT).Methods: A retrospective analysis of patients with ALVOS who underwent early endovascular treatment in Yijishan Hospital,First Affiliated Hospital of Wannan Medical College from July 2015 to December 2020,collected and recorded the patients’ baseline data,laboratory data,surgical data and 90 d follow-up,and define the90 d modified Rankin scale score ≤ 2 as a good prognosis.Single factor and multivariate regression analysis were used to explore the relationship between nutritional status and 90 d functional prognosis.Results: A total of 459 patients were enrolled in this study,with an average age of(68.29±11.21)years old,260 males(56.6%),grouped according to PNI indicators:There were 392 cases of normal nutrition(85.4%),44 cases of moderate malnutrition(9.6%),and 23 cases of severe malnutrition(5.0%).Univariate analysis showed the good prognosis group has a higher proportion of no malnutrition,younger age,lower proportion of diabetes,lower baseline blood pressure,lower baseline NIHSS score,higher baseline ASPECT score,higher proportion of good collateral circulation and complete vascular recanalization.Multivariate analysis showed that in addition to age,diabetes,baseline systolic blood pressure,successful recanalization,baseline ASPECT score,baseline NIHSS score and collateral circulation,nutritional status PNI is a protective factor for a good 90 d prognosis of patients received EVT(moderate vs severe OR=0.245,95%CI: 0.066～0.908,P=0.035;normal vs severe OR=0.185,95%CI:0.059～0.581,P=0.004).On subgroup analysis,the univariate results showed a significant difference between the PNI subgroup in the good prognosis group and the poor prognosis group(P=0.028).Multifactorial analysis showed that the PNI subgroup(moderate vs severe OR=0.244,95% CI: 0.058～1.020,P=0.053;normal vs severe OR=0.173,95% CI: 0.050～ 0.592,P=0.005)was an influential factor in the prognosis of recanalized patients.PNI grouping in the unrecanalized group was not associated with poor prognosis(P=0.665).Conclusion: Nutritional status is one of the important factors affecting the prognosis of patients treated with EVT.Advanced age,history of diabetes,high baseline systolic blood pressure,low baseline ASPECT score,and high baseline NIHSS score were risk factors for 90 d prognosis,and successful revascularization and good collateral circulation were protective factors for 90 d prognosis.Nutritional status in the recanalzed group can also influence the 90 d prognosis of patients.