Late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke
Abstract Purpose This study aimed to investigate whether late neurological improvement (LNI) during hospitalization serves as a favorable prognostic indicator in patients with acute ischemic stroke (AIS) and to identify the predictors of LNI. Methods We retrospectively analyzed data from the Safe Im...
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BMC
2025-04-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-02469-8 |
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| author | Huimin Zhao Qinrong Xu Peng Chen Xiaojing Guo Guanhui Wu |
| author_facet | Huimin Zhao Qinrong Xu Peng Chen Xiaojing Guo Guanhui Wu |
| author_sort | Huimin Zhao |
| collection | DOAJ |
| description | Abstract Purpose This study aimed to investigate whether late neurological improvement (LNI) during hospitalization serves as a favorable prognostic indicator in patients with acute ischemic stroke (AIS) and to identify the predictors of LNI. Methods We retrospectively analyzed data from the Safe Implementation of Treatments in Stroke (SITS) registry at two stroke centers in Egypt. LNI was defined as the lack of early neurological improvement (ENI) within 24 h after admission, accompanied by neurological improvement within 7 days of hospitalization. Multivariate logistic regression was employed to analyze the factors influencing favorable prognosis (modified Rankin Scale score 0–2) and LNI. Results A total of 834 patients with AIS were included in this study, of which 130 (15.6%) exhibited LNI. Among these, 99 (76.2%) achieved favorable outcomes. Both ENI (OR = 6.756, 95% CI 3.355–13.603, P < 0.001) and LNI (OR = 5.760, 95% CI 3.146–10.545, P < 0.001) were independently associated with favorable prognosis after adjustment. Predictors of LNI in multivariable-adjusted logistic regression included younger age (OR = 0.973, 95% CI 0.957–0.990, P = 0.001), higher baseline National Institutes of Health Scale (NIHSS) score (OR = 1.196, 95% CI 1.146–1.248, P < 0.001), and rt-PA treatment (OR = 1.953, 95% CI 1.206–3.163, P = 0.006). Conclusions Approximately three-quarters of patients with LNI are expected to achieve good outcome. LNI was a favorable prognostic indicator in patients with AIS and younger age, higher baseline NIHSS score and rt-PA treatment predicted LNI. |
| format | Article |
| id | doaj-art-7abf56a69f014d7e8781ee1d1379b92a |
| institution | OA Journals |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-7abf56a69f014d7e8781ee1d1379b92a2025-08-20T02:30:22ZengBMCEuropean Journal of Medical Research2047-783X2025-04-013011710.1186/s40001-025-02469-8Late neurological improvement during hospitalization is a predicative factor for acute ischemic strokeHuimin Zhao0Qinrong Xu1Peng Chen2Xiaojing Guo3Guanhui Wu4Department of Neurology, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, the Affiliated Suzhou Hospital of Nanjing Medical UniversityDepartment of Neurology, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, the Affiliated Suzhou Hospital of Nanjing Medical UniversityDepartment of Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, the Affiliated Guangji Hospital of Soochow UniversityDepartment of Neurology, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, the Affiliated Suzhou Hospital of Nanjing Medical UniversityDepartment of Neurology, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, the Affiliated Suzhou Hospital of Nanjing Medical UniversityAbstract Purpose This study aimed to investigate whether late neurological improvement (LNI) during hospitalization serves as a favorable prognostic indicator in patients with acute ischemic stroke (AIS) and to identify the predictors of LNI. Methods We retrospectively analyzed data from the Safe Implementation of Treatments in Stroke (SITS) registry at two stroke centers in Egypt. LNI was defined as the lack of early neurological improvement (ENI) within 24 h after admission, accompanied by neurological improvement within 7 days of hospitalization. Multivariate logistic regression was employed to analyze the factors influencing favorable prognosis (modified Rankin Scale score 0–2) and LNI. Results A total of 834 patients with AIS were included in this study, of which 130 (15.6%) exhibited LNI. Among these, 99 (76.2%) achieved favorable outcomes. Both ENI (OR = 6.756, 95% CI 3.355–13.603, P < 0.001) and LNI (OR = 5.760, 95% CI 3.146–10.545, P < 0.001) were independently associated with favorable prognosis after adjustment. Predictors of LNI in multivariable-adjusted logistic regression included younger age (OR = 0.973, 95% CI 0.957–0.990, P = 0.001), higher baseline National Institutes of Health Scale (NIHSS) score (OR = 1.196, 95% CI 1.146–1.248, P < 0.001), and rt-PA treatment (OR = 1.953, 95% CI 1.206–3.163, P = 0.006). Conclusions Approximately three-quarters of patients with LNI are expected to achieve good outcome. LNI was a favorable prognostic indicator in patients with AIS and younger age, higher baseline NIHSS score and rt-PA treatment predicted LNI.https://doi.org/10.1186/s40001-025-02469-8Early neurological improvementLate neurological improvementPrognosisAcute ischemic stroke |
| spellingShingle | Huimin Zhao Qinrong Xu Peng Chen Xiaojing Guo Guanhui Wu Late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke European Journal of Medical Research Early neurological improvement Late neurological improvement Prognosis Acute ischemic stroke |
| title | Late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke |
| title_full | Late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke |
| title_fullStr | Late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke |
| title_full_unstemmed | Late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke |
| title_short | Late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke |
| title_sort | late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke |
| topic | Early neurological improvement Late neurological improvement Prognosis Acute ischemic stroke |
| url | https://doi.org/10.1186/s40001-025-02469-8 |
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