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...

Full description

Saved in:
Bibliographic Details
Main Authors: Huimin Zhao, Qinrong Xu, Peng Chen, Xiaojing Guo, Guanhui Wu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:European Journal of Medical Research
Subjects:
Online Access:https://doi.org/10.1186/s40001-025-02469-8
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850139280615145472
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
work_keys_str_mv AT huiminzhao lateneurologicalimprovementduringhospitalizationisapredicativefactorforacuteischemicstroke
AT qinrongxu lateneurologicalimprovementduringhospitalizationisapredicativefactorforacuteischemicstroke
AT pengchen lateneurologicalimprovementduringhospitalizationisapredicativefactorforacuteischemicstroke
AT xiaojingguo lateneurologicalimprovementduringhospitalizationisapredicativefactorforacuteischemicstroke
AT guanhuiwu lateneurologicalimprovementduringhospitalizationisapredicativefactorforacuteischemicstroke