Predictors and outcome of deterioration during admission in patients with cerebral venous thrombosis

European Stroke Journal, Год журнала: 2025, Номер unknown

Опубликована: Фев. 11, 2025

Introduction: Cerebral venous thrombosis (CVT) is a less common stroke subtype. While long term outcome factors have been extensively studied, short deterioration remains poorly understood. Patients and methods: We conducted 10-years retrospective analysis at high-volume tertiary center, including consecutive patients diagnosed with CVT. The primary was early (ED), defined as decrease in Glasgow Coma Scale, de novo or worsening of focal deficit, death from neurological cause, new enlarged parenchymal lesions subarachnoid hemorrhage during hospitalization. Multivariable logistic regression performed to identify associated ED. Results: included 138 (81.2% female, median age 42.0 years (IQR 29.3–49.0)). Forty-five (32.6%) had ED, 33 (23.9%) showing clinical 35 104 (33.7%) imaging worsening. Variables selected the multivariate model for association ED were aphasia (OR 4.63, 95% CI 1.61–13.32), motor deficits 2.34, 0.97–5.61), lesion 3.65, 1.38–9.67). Twenty-seven underwent endovascular treatment after deterioration. group worse functional discharge, 6 12 months ( p < 0.001). Discussion: One third this cohort experienced aphasia, brain baseline higher risk. These follow-up. Conclusion: identified predictors should be carefully monitored. findings may inform design future trials aimed evaluating additional therapeutic interventions acute phase.

Язык: Английский

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Usefulness of Serum NOX4 as a Potential Biomarker to Predict Early Neurological Deterioration and Poor Outcome of Spontaneous Intracerebral Hemorrhage: A Prospective Observational Study

Neuropsychiatric Disease and Treatment, Год журнала: 2025, Номер Volume 21, С. 295 - 307

Опубликована: Фев. 1, 2025

NADPH oxidase 4 (NOX4) may play a critical role for inducing oxidative stress and inflammation after spontaneous intracerebral hemorrhage (sICH). This study was performed to assess associations of serum NOX4 levels with sICH severity, early neurological deterioration (END) outcomes. In this prospective cohort study, 161 patients controls were collected quantifying levels. END defined as decrease ≥2 points in Glasgow coma scale (GCS) score within 24 hours admission. Poor outcome referred Outcome Scale (GOS) scores 1-3 at 90 days post-stroke. As compared controls, significant increase observed among patients. independently associated GCS hematoma volumes (all P<0.05). The significantly higher than those without, poor good outcome, well predicted both (OR=3.166, 95% CI 1.237-8.105, P=0.016) 90-day prognosis (OR=3.031, 1.111-8.269, P=0.030). Serum differentiated risk (area under ROC curve (AUC), 0.768; confidence interval (CI), 0.695-0.831) (AUC, 0.777; CI, 0.705-0.839), which had similar prognostic ability, P>0.05). Elevated during the period are closely related stroke outcome. Hypothetically, serve potential biomarker sICH.

Язык: Английский

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Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study

Frontiers in Neurology, Год журнала: 2025, Номер 15

Опубликована: Янв. 7, 2025

Intracerebral hemorrhage (ICH) is a common cerebrovascular disease characterized by high mortality and disability rates. Neuritin, significantly expressed in injured brain tissues, implicated the molecular mechanisms underlying acute injury. We aimed to explore prognostic predictive value of serum neuritin ICH. In this prospective cohort study, levels were measured at admission 202 patients, on post-ICH days 1, 3, 5, 7, 10 54 these time enrollment 100 healthy controls. The Glasgow Coma Scale (GCS) hematoma volume used as severity indicators. A poor prognosis was defined modified Rankin (mRS) score 3-6 90 after END decrease ≥2 points GCS within 24 h admission. multivariate logistic regression model assess independent relationships between levels, END, prognosis. Serum increased patient admission, continued rise day peaked then gradually diminished from 5 until 10. remained substantially higher patients compared controls throughout 10-day period. independently related scores volume. subgroup analyses, showed linear relationship with likelihood experiencing 90-day mark Additionally, associated ordinal mRS scores, Under receiver operating characteristic (ROC) curve analysis, effectively predicted both Two models incorporating GCS, volume, developed represented using two nomograms separately estimate risks These demonstrated clinical efficiency, stability, validity ROC, calibration, decision analyses. Internal validation conducted randomly extracted subset 101 patients. Furthermore, specific weighted scoring systems optimize prediction Elevated are strongly severity, neurological outcomes following ICH, establishing potential biomarker for

Язык: Английский

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Prognostic Significance of Serum NLRP3 in Spontaneous Intracerebral Hemorrhage

International Journal of General Medicine, Год журнала: 2025, Номер Volume 18, С. 745 - 757

Опубликована: Фев. 1, 2025

Background: Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) is involved in secondary brain injury after acute intracerebral hemorrhage (ICH). The objective of this study was to determine its ability predict early neurological deterioration (END) and 3-month outcome ICH. Methods: In prospective cohort study, serum NLRP3 levels were measured 128 patients with sICH 100 healthy controls. National institute health stroke scale (NIHSS) scores hematoma volumes recorded. Post-ICH END poor (modified Rankin Scale (mRS) 3– 6) documented. results assessed using multivariate analysis. Results: Serum increased significantly as compared controls (P< 0.001). independently correlated (β=0.046; 95% confidence interval (CI), 0.020– 0.072; P=0.001) NIHSS (β=0.071; CI, 0.004– 0.139; P=0.039), forecasted (OR=1.268; 0.892– 1.801; P=0.036) prognosis at post-ICH months (OR=1.448; 1.006– 2.085; P=0.046), predictive them areas under receiver operating characteristic curve 0.788 (95% 0.706– 0.855) 0.805 0.725– 0.870) separately. levels, along the two independent predictors, that are volumes, combined establish prediction models prognosis. worked well by applying a series statistical methods. Conclusion: Increased ICH associated bleeding severity, adverse outcomes patients, meaning may be potential prognostic biomarker sICH. Keywords: hemorrhage, disease deterioration, outcome,

Язык: Английский

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Nomogram-Based Prediction of 3-Month Unfavorable Outcome and Early Neurological Deterioration After Endovascular Thrombectomy in Acute Ischemic Stroke

Therapeutics and Clinical Risk Management, Год журнала: 2025, Номер Volume 21, С. 239 - 256

Опубликована: Фев. 1, 2025

Some acute ischemic stroke (AIS) patients due to large-vessel occlusion, who underwent endovascular thrombectomy (EVT), continue experience unfavorable outcomes. Furthermore, the impact of internal carotid artery (ICA) tortuosity remains uncertain. This study aimed determine value ICA and clinical features in predicting 3-month outcome early neurological deterioration (END) after EVT AIS through nomograms. A total 313 treated with at First Affiliated Hospital Xi'an Jiaotong University were retrospectively analyzed randomized into two cohorts: training cohort (n=219) validation (n=94). After selection relevant features, nomograms for (mRS > 2) END (an increase NIHSS score ≥4 within 24 hours) established. The predictive accuracy was evaluated using ROC curves, calibration plots, decision curve analysis (DCA). Among patients, observed 19.50% (extracranial) 21.10% (cavernous) patients. 53.30% experienced a outcome, while occurred 15.70%. independent predictors included age, score, puncture-to-recanalization time, eTICI blood glucose. addition (extracranial cavernous tortuosity) resulted significant improvement model differentiation. nomogram that achieved an AUC 0.826 0.803 cohorts. ASPECT occlusion site, number retriever passes, glucose identified as factors associated END. 0.770 0.772 However, incorporation did not significantly enhance characteristics improve discrimination outcome. can be used guidance decision-making.

Язык: Английский

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Evaluation of Prognostic Implication of Serum Mixed Lineage Kinase Domain‐Like Protein in Acute Primary Supratentorial Intracerebral Hemorrhage: A Multicenter Prospective Cohort Study

Brain and Behavior, Год журнала: 2025, Номер 15(3)

Опубликована: Март 1, 2025

Abstract Objective Mixed lineage kinase domain‐like protein (MLKL) is a key component of necroptosis. Here, serum MLKL levels were measured with the intent to assess its prognostic significance in acute intracerebral hemorrhage (ICH). Methods A collective 161 patients primary supratentorial ICH and 73 controls enlisted this multicenter prospective cohort study. Serum at admission all patients, study entry controls, on post‐ICH days 1, 3, 5, 7, 10, 15 patients. Multivariate analyses adopted relationships between levels, severity, early neurological deterioration (END), poststroke 6‐month modified Rankin Scale (mRS) scores, poor prognosis (mRS scores 3–6). Results Patients, relative had significantly promoted from until Day 15, peaking value 3 ( p < 0.001). Admission independently correlated National Institutes Health Stroke (NIHSS) (beta, 0.133; 95% confidence interval (CI), 0.088–0.178; = 0.011), hematoma volume 0.051; 95%CI, 0.037–0.064; 0.001), mRS 0.707; 0.487–0.927; 0.023), as well predicted END (odds ratio, 1.902; 1.229–2.945; 0.014) 2.286; 1.324–3.946; 0.038). linearly connected risks > 0.05) 0.05), no interactions age, gender, hypertension, so forth (all possessed similar areas under receiver operating characteristic curve NIHSS 0.05). The models integrating graphically represented by nomogram good consistency calibration curve. Conclusions are markedly increased shortly following ICH, may accurately mirror disease efficaciously anticipate six‐month bad strengthening biomarker prospect ICH.

Язык: Английский

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Stress hyperglycemia indexes and early neurological deterioration in spontaneous intracerebral hemorrhage

Neurological Sciences, Год журнала: 2025, Номер unknown

Опубликована: Март 19, 2025

Abstract Aim To evaluate the relationship of early neurological deterioration (END) with admission glycemia (aG) and new stress hyperglycemia indexes in spontaneous intracerebral hemorrhage (ICH) patients. Methods The present retrospective study included 171 ICH patients from two stroke centers. END was defined as an increase ≥ 4 points National Institutes Health Stroke Scale and/or a decrease 2 Glasgow Coma within 72 hours admission. were glycemic gap (GGAP), ratio (SHR), glucose-glycated hemoglobin ratio. GGAP calculated aG – 28,7*glycated + 46,7; SHR / (28,7*glycated 46,7); Glucose-glycated glycated hemoglobin. We performed univariate multivariate analyses for END. receiver operating characteristic curves built END-related measures; area under (AUC) compared. optimized threshold values calculated, significant measures dichotomized. Univariate dichotomized measures. Results 21 (12.3%) significantly associated GGAP, ratio, but not aG. AUC three did differ significantly. cutoffs 35.68 (sensitivity 0.47, specificity 0.81), 1.15 0.62, 0.68), 26.67(sensitivity 0.43, 0.80) SHR, respectively. also all expressed categorical variables. Conclusion predictors

Язык: Английский

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Feasibility of Serum Peroxiredoxin 2 as a Biochemical Indicator for Reflecting Severity and Prognosticating Stroke-Associated Pneumonia, Early Neurological Deterioration and Poor Neurological Outcomes in Acute Supratentorial Intracerebral Hemorrhage: An Observational Analytical Clinical Study

Neuropsychiatric Disease and Treatment, Год журнала: 2025, Номер Volume 21, С. 621 - 640

Опубликована: Март 1, 2025

Peroxiredoxin 2 (Prdx2) functions as an antioxidant and may be involved in acute brain injury. This study aimed to investigate whether Prdx2 can act a serological marker for assessing the severity forecasting stroke-associated pneumonia (SAP), early neurological deterioration (END), outcomes intracerebral hemorrhage (ICH). A collective of 167 patients with ICH 61 controls underwent quantifications serum levels. In addition, them allowed measurements on days 1, 3, 5, 7, 10, 14 post-ICH. Admission National Institutes Health Stroke Scale (NIHSS) score hematoma size were documented, modified Rankin (mRS) at six-month mark following was registered. Correlations between END, SAP, poor prognosis (mRS scores 3-6) determined using multivariate models. Serum levels rapidly increased after stroke, highest day substantially higher during initial than those controls. closely related NIHSS scores, size, mRS linearly relevant likelihoods prognosis, independently predictive prognosis. These associations not markedly affected by age, sex, hypertension, or other factors subgroup analysis. Moreover, possibilities efficiently distinguished Its discrimination efficiency similar size. The combination three variables displayed ability volume prediction. marked increase accurately mirror hemorrhagic effectively predict outcomes, solidifying prognosticator ICH.

Язык: Английский

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A prospective cohort study on serum PINK1 as a biochemical marker in relation to poor neurological prognosis, stroke-associated pneumonia and early neurological deterioration after acute intracerebral hemorrhage

Clinica Chimica Acta, Год журнала: 2025, Номер unknown, С. 120282 - 120282

Опубликована: Апрель 1, 2025

Язык: Английский

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Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study

Frontiers in Neurology, Год журнала: 2025, Номер 16

Опубликована: Апрель 24, 2025

Background A20 is an endogenous protective protein. We quantified serum levels following acute intracerebral hemorrhage (ICH) and assessed their association with the severity of illness clinical outcomes patients. Methods In total, 243 patients supratentorial ICH 76 controls were included in this prospective cohort study. Serum measured at admission all patients, study entry controls, on post-ICH days 1, 3, 5, 7, 10, 14 The National Institutes Health Stroke Scale (NIHSS) scores hematoma volume used to estimate severity. Stroke-associated pneumonia (SAP), early neurological deterioration (END), 6-month poor prognosis (modified Rankin scores: 3–6) considered as three outcome variables interest. Results Patients, opposed exhibited significantly heightened from until ICH, a peak value day 3. all-time points after which correlated NIHSS volume, higher END, SAP, or than those without corresponding one. possessed similar predictive ability these other time points. admission, along initial remained independent predictors among As confirmed by numerous statistical approaches, conjunctions comprised prediction models: satisfactory stability, validity, discrimination efficiency. Conclusion increased may accurately reflect hemorrhagic effectively predict prognosis, suggesting that be promising prognostic biomarker for ICH.

Язык: Английский

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