Correlation of THRIVE score,NLR,and D-dimer with prognosis in patients undergoing thrombectomy for acute ischemic stroke
LIANG Bing-song
ZHANG Qi-ping
LI Yu-ying
LI Jian
CHEN Ying-dao
Abstract：Objective To analyze the correlation between pre-thrombectomy THRIVE score,neutrophil-lym-phocyte ratio(NLR),and D-dimer levels with the prognosis of patients undergoing endovascular treatment(EVT)for a-cute ischemic stroke,and to explore their predictive value for adverse outcomes.Methods A retrospective study was conducted on the clinical data of 165 patients who underwent anterior circulation thrombectomy.Patients were categorized based on their 90-day modified Rankin Scale(mRS)scores into a good outcome group(mRS 0-3)and a poor outcome group(mRS 4-6).The primary outcome was the mRS score at 90 days post-thrombectomy,while secondary outcomes included symptomatic intracranial hemorrhage and/or malignant cerebral edema(MCE)within 3 days post-surgery,and 30-day mortality rate.Univariate and multivariate logistic regression models were used to identify related factors,and re-ceiver operating characteristic(ROC)curves were used to analyze the predictive value of these factors for adverse out-comes.Results In the poor outcome group,age,baseline NIH Stroke Scale(NIHSS)scores,DSA-collateral circula-tion,THRIVE scores,NLR values,and D-dimer levels were significantly different compared to the good outcome group(P＜0.05).Multivariate logistic regression analysis indicated that baseline NIHSS scores,DSA-collateral circulation,THRIVE scores,preoperative NLR,and D-dimer levels were associated with poor outcomes post-thrombectomy(P＜0.05).The area under the ROC curve(AUC)for baseline NIHSS,THRIVE scores,NLR,and D-dimer were 0.829,0.768,0.921,and 0.732,respectively.When combining THRIVE score,preoperative NLR,and D-dimer,the AUC increased to 0.957(95％CI:0.929-0.985,P=0.000),showing a statistically significant difference(P＜0.05).Conclusion THRIVE score,preoperative NLR,and D-dimer levels are closely related to adverse outcomes following EVT for acute ischemic stroke.Baseline NIHSS scores and DS A-collateral circulation are also independent risk factors for poor outcomes.The combined use of THRIVE scores,preoperative NLR,and D-dimer levels provides effective pre-diction of adverse prognoses,offering significant guidance for clinical practice.
Keywords：thrombectomyvascular event health risk scoreneutrophil-lymphocyte percentageD-dimeradverse outcome
Publication Date：2024-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 757-762 )