TIÊN LƯỢNG MỨC ĐỘ NẶNG SAU CAN THIỆP TÁI THÔNG THÀNH CÔNG DO TẮC ĐỘNG MẠCH NÃO GIỮA ĐOẠN M1

Abstract

Background: Acute ischemic stroke due to M1 segment middle cerebral artery occlusion is associated with severe outcome. Despite successful reperfusion, clinical outcome is not always favorable. This study aimed to identify clinical and subclinical factors predicting unfavorable outcome after successful thrombectomy. Materials and methods: A prospective study was conducted on patients with acute ischemic stroke due to M1 segment middle cerebral artery occlusion successfully reperfused at Cho Ray Hospital (January 2023–December 2024). Logistic regression was used to analyze factors associated with unfavorable outcome (modified Rankin Scale – mRS 3-6) at 90 days. Results: Among 48 patients, 39.6% patients had unfavorable outcome (mRS 3-6). NIHSS score at 24 hours was a strong independent predictor (OR=1.413; 95%CI: 1.164–1.716; p<0.001). An NIHSS 24-hour threshold ≥10 likely predicted unfavorable outcome (AUC=0.880; sensitivity 89.5%; specificity 72.4%). The logistic regression equation predicting outcome was Logit (mRS 3–6) = −4.121 + 0.346 × NIHSS24hour. Conclusion: The NIHSS score at 24 hours is a strong, reliable, and independent early predictor of unfavorable outcome after successful thrombectomy for M1 segment middle cerebral artery occlusion.