Outcome prediction for patients with anterior circulation acute ischemic stroke following endovascular treatment: A single-center study

Xiao Wu; Guoqing Liu; Wu Zhou; Aihua Ou; Xian Liu; Yuhan Wang; Sifan Zhou; Wenting Luo; Bo Liu

doi:10.3892/etm.2019.8054

Outcome prediction for patients with anterior circulation acute ischemic stroke following endovascular treatment: A single-center study

Exp Ther Med. 2019 Nov;18(5):3869-3876. doi: 10.3892/etm.2019.8054. Epub 2019 Sep 25.

Authors

Xiao Wu¹, Guoqing Liu², Wu Zhou³, Aihua Ou⁴, Xian Liu², Yuhan Wang¹, Sifan Zhou¹, Wenting Luo¹, Bo Liu²

Affiliations

¹ The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China.
² Department of Radiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China.
³ The Medical Imaging Laboratory, School of Medical Information Engineering, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, P.R. China.
⁴ Department of Statistics and Epidemiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China.

Abstract

Previous studies have identified various factors associated with the outcomes of acute ischemic stroke (AIS) but considered only 1 or 2 predictive factors. The present study aimed to use outcome-related factors derived from biochemical, imaging and clinical data to establish a logistic regression model that can predict the outcome of patients with AIS following endovascular treatment (EVT). The data of 118 patients with anterior circulation AIS (ACAIS) who underwent EVT between October 2014 and August 2018 were retrospectively analyzed. The patients were divided into 2 groups based on the modified Rankin Scale score at three months after surgery, where 0-2 points were considered to indicate a favorable outcome and 3-6 points were considered a poor outcome. Non-conditional logistic stepwise regression was used to identify independent variables that were significantly associated with patient outcome, which were subsequently used to establish a predictive statistical model, receiver operating characteristic (ROC) curve was used to show the performance of statistical model and analyze the specific association between each factor and outcome. Among the 118 patients, 47 (39.83%) exhibited a good and 71 (60.17%) exhibited a poor outcome. Multivariate analysis revealed that the predictive model was statistically significant (χ²=78.92; P<0.001), and that the predictive accuracy of the model was 83.1%, which was higher compared with that obtained using only a single factor. ROC curve analysis shows the area under curve of the statistical model was 0.823, the analysis of diagnostic threshold for prognostic factors indicated that age, diffusion-weighted imaging lesion volume, glucose on admission, National Institutes of Health Stroke Scale score on admission and hypersensitive C-reactive protein were valuable predictive factors for the outcome of EVT (P<0.05). In conclusion, a predictive model based on non-conditional logistic stepwise regression analysis was able to predict the outcome of EVT for patients with ACAIS.

Keywords: acute ischemic stroke; biochemical indicators; clinical factors; endovascular treatment; imaging characteristics; infarct lesion volume; outcome prediction.