Predictors of Poor Outcome in Patients with Minor Ischemic Stroke by Using Magnetic Resonance Imaging

J Mol Neurosci. 2019 Nov;69(3):478-484. doi: 10.1007/s12031-019-01379-9. Epub 2019 Jul 20.

Abstract

Although the symptoms of minor ischemic stroke are mild, poor prognosis may occur if left untreated. Therefore, it is particularly important to identify the predictors that associated with poor outcome in patients presenting minor ischemic stroke. The aim of this study was to elucidate the predictors of progression by using magnetic resonance imaging (MRI). A total of 516 patients diagnosed with minor ischemic stroke were enrolled in this study. They were divided into two groups, the progressive group and non-progressive group, according to the modified Rankin Scale (mRS) with the cutoff value of 2 points on day 90 after the stroke onset. We compared the results of MRI scan between the two groups to investigate the potential independent determinants of progression using multivariate logistic regression analysis. Ninety of 516 patients (17.44%) underwent progression. There were 9 factors that were independently associated with poor outcome, including age (OR = 1.045, 95% CI 1.017-1.074), heart disease (OR = 2.021, 95% CI 1.063-3.841), baseline NIHSS score (OR = 1.662, 95% CI 1.177-2.347), limb motor disturbance (OR = 2.430, 95% CI 1.010-5.850), ataxia (OR = 2.929, 95% CI 1.188-7.221), early neurological deterioration (OR = 50.994, 95% CI 17.659-147.258), diameter of infarction (OR = 1.279, 95% CI 1.075-1.521), non-responsible vessel size (OR = 2.518, 95% CI 1.145-5.536), and large-artery atherosclerosis (OR = 2.010, 95% CI 1.009-4.003). This study indicated that age, heart disease, motor disturbance of limb, ataxia, early neurological deterioration, diameter of infarction, size of non-responsible vessels, and large-artery atherosclerosis can be used to assess the prognosis of patients with minor ischemic stroke.

Keywords: MRI; Minor ischemic stroke; Risk factor; Stroke progression.

MeSH terms

  • Age Factors
  • Aged
  • Angiography
  • Ataxia / etiology
  • Atherosclerosis / complications
  • Blood Vessels / diagnostic imaging
  • Blood Vessels / pathology
  • Brain Damage, Chronic / etiology*
  • Brain Ischemia / complications
  • Brain Ischemia / diagnostic imaging*
  • Brain Ischemia / mortality
  • Carotid Arteries / diagnostic imaging
  • Comorbidity
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Movement Disorders / etiology
  • Multivariate Analysis
  • Neuroimaging*
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome