Analysis of risk factors of poor prognosis after recanalization treatment of anterior and posterior circulation tandem lesions

Abstract

Objective To analyze the prognosis and risk factors of the anterior and posteriorcirculation tandem lesions (TLs) patients after recanalization treatment. Methods The general and clinicaldata of 42 patients with TLs who received recanalization treatment in Shijiazhuang People's Hospital fromApril 2019 to August 2022 were retrospectively collected. The prognosis of 90 d after surgery wasevaluated by the modified Rankin Scale (mRS). Univariate and multivariate stepwise Logistic regressionanalyses were used to investigated the risk factors of poor prognosis of TLs. Results According to mRSscores at the 90 d after surgery, the patients were divided into good prognosis group (mRS ≤ 2, n = 21) andpoor prognosis group (mRS > 2, n = 21). The National Institutes of Health Stroke Scale (NIHSS) score atadmission (Z = ⁃ 2.916, P = 0.004), time from onset to recanalization (Z = ⁃ 2.048, P = 0.041), mechanicalthrombectomy times ≥ 3 (χ2 = 4.725, P = 0.030) and the proportion of hematoma type hemorrhagictransformation (χ2 = 8.400, P = 0.004) in the poor prognosis group were higher than those in good prognosisgroup. Logistic regression analysis showed that high NIHSS score at admission (OR = 12.457, 95%CI:2.066-75.120; P = 0.006), mechanical thrombectomy times ≥ 3 (OR = 9.387, 95%CI: 1.222-72.140; P =0.031) and postoperative hemorrhagic transformation (OR = 7.237, 95%CI: 1.019-51.403; P = 0.048) were risk factors of poor prognosis of TLs. Conclusions Anterior and posterior circulation TLs patients withlower NHISS score at admission, mechanical thrombectomy times < 3 and without postoperative hemorrhagictransformation may have good prognosis.

doi：10.3969/j.issn.1672⁃6731.2024.11.009