Abstract P665: Different Predictive Factors for Early Neurological Deterioration Based on the Location of Single Subcortical Infarction

Abstract

Introduction: Patients with single subcortical infarction (SSI) have relatively favorable prognosis, but they often experience early neurological deterioration (END) in a clinical course. In addition, SSI is considered to differ in its prognosis and mechanism depending on the location of the lesion. Hypothesis: We compared the predictors for END in patients with SSI according to the location of the lesion. Methods: We included consecutive patients with SSI within 72 hours of symptom onset between 2010 and 2016. END was defined as an increase of ≥ 2 in the total NIHSS score or ≥ 1 in the motor NIHSS score within the first 72 hours of admission. Along with the analysis of the entire SSI patients, we also analyzed the predictors for END in the proximal/distal SSI patients and the anterior/posterior circulation SSI patients. Results: A total of 438 patients with SSI were evaluated. In multivariable analysis, initial NIHSS score [adjusted odds ratio (aOR) = 1.36, 95% confidence interval (CI): 1.15-1.60], pulsatility index (PI) (aOR = 1.25, 95% CI: 1.03-1.52), parent artery disease (PAD) (aOR = 2.14, 95% CI: 1.06-4.33), and neutrophil to lymphocyte ratio (NLR) (aOR = 1.24, 95% CI: 1.04-1.49) were positively associated with END. In patients with proximal SSI, initial NIHSS score, PI, PAD, and NLR showed positive associations with END. Meanwhile, no variable related to END was found in distal SSI. When we compared the predictors for END based on the involved vascular territory, initial NIHSS score and NLR were significantly associated with END in the anterior circulation. On the other hand, patient with SSI in the posterior circulation showed PI and PAD as independent predictors of END. Conclusions: Initial NIHSS score, PI, PAD, and NLR were associated with END in patients with SSI. The frequency and predictors for END were different depending on the location of SSI lesion.