Influencing Factors of Early Neurological Deterioration and Short-Term Prognosis after Intravenous Thrombolysis in Patients with Acute Ischemic Stroke

Objective To explore the factors affecting the early neurological deterioration (END) and short-term prognosis of patients with acute ischemic stroke (AIS) after intravenous thrombolysis.Methods The clinical data of 212 patients with AIS who received intravenous thrombolysis in our hospital from July 2017 to November 2020 were selected and divided into the END group ( n  = 71) and the non-END group ( n  = 141) according to the National Institute of Health Stroke Scale (NIHSS) score and divided into the poor prognosis group ( n  = 85) and the good prognosis group ( n  = 127) according to the modified Rankin scale (mRS) score at discharge. The basic data of patients, vascular risk factors, imaging examinations, and laboratory indicators were collected. A logistic regression model was used to analyze the influencing factors of END and the short-term prognosis of AIS patients after intravenous thrombolysis.Results Univariate analysis showed that the patient's age, time from onset to treatment (OTT), NIHSS score, diabetes, hypertension, atrial fibrillation, TOAST classification, infarct size, carotid artery stenosis, white blood cell count (WBC), C-reactive protein (CRP), and D-dimer (DD) were associated with END ( P < 0.05). Multiple logistic regression analysis found that NIHSS score, diabetes, atrial fibrillation, infarct size, carotid stenosis, and CRP were independent influencing factors of END after intravenous thrombolysis in AIS patients ( P < 0.05). Univariate analysis showed that the patient's age, OTT, NIHSS score, diabetes, hypertension, atrial fibrillation, infarct size, carotid stenosis, and the occurrence of END were all related to the short-term prognosis of AIS patients ( P < 0.05). Multiple logistic regression analysis showed that age, NIHSS score, infarct size, carotid artery stenosis, and the occurrence of END were all independent factors affecting the short-term prognosis of AIS patients.Conclusion High NIHSS score, combined with diabetes, atrial fibrillation, moderate to severe carotid stenosis, and elevated CRP are all risk factors for END after intravenous thrombolysis in AIS patients. Moreover, advanced age, high NIHSS score, moderate to severe carotid stenosis, and occurrence of END are risk factors for poor short-term prognosis after intravenous thrombolysis in AIS patients.