Predictors of early neurologic deterioration in patients with acute ischemic stroke

Abstract

Objective To investigate the risk factors for early neurologic deterioration (END) in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke were enrolled retrospectively. The clinical data and laboratory findings of the patient were collected. They were divided into an END group and a non-END group at day 7 after onset according to the changes of the National Institutes of Health Stroke Scale (NIHSS) scores. END was defined as NIHSS scores increasing ≥3 scores compared with the baseline level. Multivariate logistic regression analysis was used to determine the independent risk factors for END in patients with acute ischemic stroke. Results A total of 328 patients with acute ischemic stroke were enrolled, 74 (22.6%) had END, 254 (77.4%) did not have END. The proportions of male, hypertension, history of previous stroke or TIA, brainstem or cerebellar infarction, using antihypertensive drugs in patients before admission, and systolic blood pressure before admission in the END group were significantly higher than those in the non-END group (all P<0.05). White blood cell count, neutrophil percentage, low-density lipoprotein cholesterol, fasting blood glucose, homocysteine, C-reactive protein, and fibrinogen levels were significantly higher than those in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that the higher white blood cell count (odds ratio, [OR] 2.126, 95% confidence interval [CI] 1.240-4.325; P=0.028), low-density lipoprotein cholesterol (OR 2.486, 95% CI 1.932-6.021; P=0.036), homocysteine (OR 2.787, 95% CI 1.194-6.902; P=0.036), and C-reactive protein (OR 3.416, 95% CI 1.552-10.650; P=0.032) were the independent predictors of occurring END in patients with acute ischemic stroke. Conclusion White blood cell count, low-density lipoprotein cholesterol, higher homocysteine and C-reactive protein are the independent predictors of END in patients with acute ischemic stroke. Key words: Stroke; Brain Ischemia; Disease Progression; Biological Markers; Risk Factors