The risk factors for the prognosis in patients with recent single subcortical infarction

Abstract

Background White matter hyperintensity (WMH) is an imaging markers of cerebral small vessel disease (CSVD), which often coexists with recent single subcortical infarct (RSSI). This study aimed to explore the risk factors of poor functional prognosis in patients with RSSI. Methods A total of 432 patients with RSSI from June 2018 to December 2019 in West China Hospital, Sichuan University were analyzed retrospectively. WMH [including paraventricular white matter hyperintensity (PWMH) and deep white matter hyperintensity (DWMH)] was evaluated by MRI. Univariate and multivariate Logistic regression analyses were used to screen for poor prognostic risk factors in patients with RSSI, stratified analyses was used to explore the stability of risk factors associated with poor prognosis in different populations. Results Logistic regression analysis showed that older age (OR=1.060, 95%CI: 1.028-1.093; P=0.000), longer time from onset to admission (OR=1.005, 95%CI: 1.002-1.008; P=0.001), higher National Institute of Health Stroke Scale (NIHSS) score at admission (OR=1.109, 95%CI: 1.047-1.175; P=0.000), larger direct diameter of infarct (OR=1.077, 95%CI: 1.028-1.129; P=0.002) and severe WMH burden (OR=2.229, 95%CI: 1.082-4.591; P=0.030) were risk factors for poor prognosis in patients with RSSI. Further stratified analysis showed that the severe WMH burden (Fazekas score 4-6) as a risk factor for poor prognosis in RSSI, which was stable in women (OR=2.460, 95%CI: 1.120-5.360; P=0.024), age＞50 years (OR=1.890, 95%CI: 1.120-3.180; P=0.017) and hypertension (OR=3.150, 95%CI: 1.230-8.100; P=0.017). Conclusions In patients with RSSI, severe WMH burden (Fazekas score 4-6) is a risk factor for 90 d poor prognosis, and it is stable in women, age＞50 years and in people with a history of hypertension.

doi：10.3969/j.issn.1672⁃6731.2021.10.005