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The following is a summary of “Clinical and imaging risk factors for early neurological deterioration and long-term neurological disability in patients with single subcortical small infarction,” published in the February 2025 issue of BMC Neurology by Feng et al.
Researchers conducted a retrospective study to assess clinical and imaging risk factors for early neurological deterioration (END) and long-term disability in patients with single subcortical small infarction (SSSI).
They included hospitalized patients with SSSI and defined outcomes as modified Rankin Scale (mRS) score >2 and END during hospitalization. Multivariate logistic regression identified predictors, and stepwise regression developed a model for poor outcomes. Predictive performance was assessed using receiver operating characteristic (ROC) curves.
The results showed that 289 patients with SSSI were included. During hospitalization, 18 patients (6.2%) experienced END, and 29 (10%) had neurological disability at a median follow-up of 21.4 months. Multivariate analysis showed that the National Institutes of Health Stroke Scale (NIHSS) (OR 1.43, 95% CI 1.19–1.73, P < 0.001) and NHR (OR 1.28, 95% CI 1.02–1.60, P = 0.034) were associated with END. Age (OR 1.08, 95% CI 1.01–1.15, P = 0.028), NIHSS (OR 1.60, 95% CI 1.29–1.98, P < 0.001), symptomatic intracranial artery stenosis (OR 5.26, 95% CI 1.56–17.71, P = 0.007), lacune number (OR 1.51, 95% CI 1.13–2.04, P = 0.006), brain atrophy (OR 2.03, 95% CI 1.19–3.46, P = 0.01), and mean hemoglobin concentration (MCHC) (OR 0.96, 95% CI 0.92–0.99, P = 0.04) were associated with neurological disability. The ROC areas for END and long-term disability models were 0.836 and 0.926, respectively.
Investigators found that high NIHSS and NHR were independent risk factors for END. Age, NIHSS, symptomatic intracranial artery stenosis, lacune number, and brain atrophy were predictors of neurological disability in patients with SSSI.
Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04067-x
