A Quantitative Study Of The Prognosis Of Muscle And Acute Stroke

Part 1:A correlation between long-term prognosis and posterior muscle mass in patients with acute strokeObjective:To study the correlation between posterior vertebral muscle group and stroke severity and adverse outcome in patients with acute stroke.Methods:The muscle area,muscle mass,BMD,degree of paravertebral fat infiltration and abdominal non-fat area of 193 patients with acute stroke were measured by quantitative CT(QCT).Kruskal-wallis,Mann-Whitney test and linear regression were used for statistical analysis.Results:Kruskal-wallis test showed that with the aggravation of stroke,muscle area,muscle mass and abdominal non-fat area were reduced to varying degrees,especially muscle area and muscle mass.The degree of paravertebral fat infiltration increased with stroke severity.Mann-Whitney test showed that the muscle mass and muscle area of patients with adverse stroke outcome were lower than those with good outcome,and the degree of paravertebral fat infiltration was higher than those with good outcome.Linear regression showed an independent negative correlation between stroke severity and muscle area(p=0.021),and muscle area was an independent predictor of adverse outcomes(adjusted R2=0.498,p=0.002).Conclusion:The mass of posterior vertebral muscle is negatively correlated with stroke severity and is an independent predictor of adverse outcome.Part Ⅱ:To explore the significance of abdominal muscle density change in the prognosis of acute stroke patientsObjective:To investigate whether the change of abdominal muscle density during hospitalization has predictive significance for the prognosis of acute stroke patients.Methods:CT was used to measure the changes in abdominal wall muscle density,paravertebral muscle density and abdominal muscle density in 140 patients with acute stroke.t test and Chi-square test were used to verify the differences between groups,ROC curve was drawn to evaluate the prediction efficiency,and multi-factor binary logistics regression analysis was used to verify the impact of muscle density changes on the outcome of stroke patients.Results:Changes in abdominal wall muscle density,paravertebral muscle density,and overall abdominal muscle density were independent predictors of outcomes and protective factors for good outcomes in patients with acute stroke(OR=0.707,95%CI:0.599-0.834,P<0.001,OR=0.762,,95%C10.671～0.864,P=0.001,OR=0.607,95%CI:0.470～0783,P<0.001)Conclusion:The change of muscle density is a reliable prognostic index of acute stroke patients.