Qian Wu1, Ai-Jie Tang2, Li Zeng3, Shu-Zhen Niu4, Mei-Mei Tian5, Ai-Ping Jin6, Hong-Yan Yang7, Jing-Juan Chen8, Zhu Xiao-Ping9, Yan Shi10. 1. Nursing Department, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, People's Republic of China; School of Medicine, Tongji University, Shanghai, People's Republic of China. Electronic address: qian_wu2010@163.com. 2. School of Medicine, Tongji University, Shanghai, People's Republic of China. Electronic address: taj1998@163.com. 3. Nursing Department, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, People's Republic of China; School of Medicine, Tongji University, Shanghai, People's Republic of China. Electronic address: aiyinsinian1986@163.com. 4. School of Medicine, Tongji University, Shanghai, People's Republic of China. Electronic address: niu_shuzhen@163.com. 5. Nursing Department, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, People's Republic of China; School of Medicine, Tongji University, Shanghai, People's Republic of China. Electronic address: tmmdaisy_1982@163.com. 6. Nursing Department, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, People's Republic of China. Electronic address: liujie554@163.com. 7. School of Medicine, Tongji University, Shanghai, People's Republic of China. Electronic address: patty_423@163.com. 8. Nursing Department, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, People's Republic of China. Electronic address: 18917683308@163.com. 9. Nursing Department, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, People's Republic of China. Electronic address: juliya1107@163.com. 10. Nursing Department, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, People's Republic of China; School of Medicine, Tongji University, Shanghai, People's Republic of China. Electronic address: 392470352@qq.com.
Abstract
OBJECTIVES: Stroke has become a national concern in China. Early prediction of stroke benefits patients and aids medical professionals in clinical decision making and rehabilitation plans to improve successful outcomes. To identify prediction factors influencing short-term outcomes in patients with acute ischemic stroke (AIS). MATERIALS AND METHODS: This was a hospital-based prospective observational study. Recovery of neurological improvement was represented by a percent reduction in the National Institutes of Health Stroke Scale (NIHSS) at discharge. We performed propensity score matching (PSM) to balance the NIHSS at admission and compared NIHSS scores before and after matching with PSM criteria. Finally, we assessed the prognosis of neurological improvement and patient-related variables. RESULTS: In the matched cohort, 92 pairs were matched by NIHSS admission after PSM. Modified Barthel Index, modified Rankin scale, NIHSS on admission, hypertension, sleep time, and Montreal Cognitive Assessment (MoCA) were statistically different between the two groups (P<0.05) before matching. Multivariable analysis identified two factors independently associated with neurological improvement: diabetes (P=0.030; adjusted odds ratio, 2.129; 95% confidence interval [CI] 1.078-4.026) and MoCA (P<0.001; adjusted odds ratio, 5.385; 95% CI 2.278-12.730). CONCLUSION: Consistent with previous studies, diabetes affected the short-term outcomes of AIS, while cognitive impairment had a negative effect on long-term AIS prognosis.Diabetes and early cognitive impairment have adverse effects on short-term prognosis after AIS.
OBJECTIVES:Stroke has become a national concern in China. Early prediction of stroke benefitspatients and aids medical professionals in clinical decision making and rehabilitation plans to improve successful outcomes. To identify prediction factors influencing short-term outcomes in patients with acute ischemic stroke (AIS). MATERIALS AND METHODS: This was a hospital-based prospective observational study. Recovery of neurological improvement was represented by a percent reduction in the National Institutes of Health Stroke Scale (NIHSS) at discharge. We performed propensity score matching (PSM) to balance the NIHSS at admission and compared NIHSS scores before and after matching with PSM criteria. Finally, we assessed the prognosis of neurological improvement and patient-related variables. RESULTS: In the matched cohort, 92 pairs were matched by NIHSS admission after PSM. Modified Barthel Index, modified Rankin scale, NIHSS on admission, hypertension, sleep time, and Montreal Cognitive Assessment (MoCA) were statistically different between the two groups (P<0.05) before matching. Multivariable analysis identified two factors independently associated with neurological improvement: diabetes (P=0.030; adjusted odds ratio, 2.129; 95% confidence interval [CI] 1.078-4.026) and MoCA (P<0.001; adjusted odds ratio, 5.385; 95% CI 2.278-12.730). CONCLUSION: Consistent with previous studies, diabetes affected the short-term outcomes of AIS, while cognitive impairment had a negative effect on long-term AIS prognosis.Diabetes and early cognitive impairment have adverse effects on short-term prognosis after AIS.