Buffer Coefficient as a Predictor of the Prognosis of Massive Cerebral Infarction

作者全名："Tan, Qing; Shen, Xia; Yang, Hongli; Xu, Xiaoyan; Guo, Yujie; He, Juan; Liu, Qingjun; Du, Xiaoyan; Wang, Dujun; Zhao, Libo"

作者地址："[Tan, Qing; Guo, Yujie; Liu, Qingjun; Du, Xiaoyan; Wang, Dujun; Zhao, Libo] Chongqing Med Univ, Dept Neurol, Yongchuan Hosp, Chongqing, Peoples R China; [Tan, Qing; Shen, Xia; Yang, Hongli] Chongqing Med Univ, Dept Neurol, Affiliated Hosp 1, Chongqing, Peoples R China; [Tan, Qing; Shen, Xia; Yang, Hongli; Xu, Xiaoyan; Guo, Yujie] Chongqing Med Univ, NHC Key Lab Diag & Treatment Brain Funct Dis, Chongqing, Peoples R China; [Xu, Xiaoyan; He, Juan] Chongqing Med Univ, Dept Pathol, Coll Basic Med, Chongqing, Peoples R China; [Liu, Qingjun; Du, Xiaoyan; Wang, Dujun; Zhao, Libo] Chongqing Key Lab Cerebrovasc Dis Res, Chongqing, Peoples R China"

通信作者："Zhao, LB (通讯作者)，Chongqing Med Univ, Dept Neurol, Yongchuan Hosp, Chongqing, Peoples R China.; Zhao, LB (通讯作者)，Chongqing Key Lab Cerebrovasc Dis Res, Chongqing, Peoples R China."

来源：WORLD NEUROSURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000970008800021

JCR分区：Q2

影响因子：2

年份：2022

卷号：168

期号：　

开始页：E538

结束页：E545

文献类型：Article

关键词：Brain edema; Buffer coefficient; Buffer volume; Ischemic stroke; Massive cerebral infarction; Predictor; Prognosis

摘要："- OBJECTIVE: To evaluate the prognostic value of the buffer coefficient, calculated as the ratio of the buffer volume (volume of intracranial cerebrospinal fluid) at the peak of brain edema to the baseline brain volume, and some other parameters in patients with massive cerebral infarction (MCI). - METHODS: The cohort comprised 161 patients with MCI who were divided into good and poor prognosis groups according to modified Rankin Scale score at 90 days after onset. Differences in clinical and imaging parameters between these groups were analyzed by univariate analysis, and multifactorial binary logistic regression analysis was used to further identify influencing factors that were significantly different. Receiver operating characteristic curve was used to evaluate the diagnostic performance between the buffer volume and the buffer coefficient. - RESULTS: The findings showed that a history of atrial fibrillation, intravenous tissue-type plasminogen activator administration, successful reperfusion, successful craniectomy, low-density lesion volume, brain volume, buffer volume, and buffer coefficient were significantly different between the poor and good prognosis groups (P < 0.05 for all comparisons). Multifactorial binary logistic regression analyses revealed that patients who had large low-density lesion volume and patients who had not achieved successful reperfusion or received intravenous tissue-type plasminogen activator were likely to have a poor prognosis (P < 0.05). The buffer coefficient was identified as an independent predictive factor for MCI (P < 0.001). The area under the receiver operating characteristic curve for the buffer coefficient was 0.862. When the cutoff value was 9.3%, sensitivity of predicting poor prognosis of patients with MCI was 94.7%. - CONCLUSIONS: The buffer coefficient has potential benefits as a prognostic indicator for MCI that can be used to detect even subtle changes in brain edema."

基金机构："Chongqing Key Program of Technological Innovation and Application Development [cstc2019jscx-gksbX0064]; Research Project of Yongchuan Hospital Affiliated to Chongqing Medical University [YJSJ202135]; Public Welfare Science and Technology Projects of Yongchuan District in 2019 [Ycstc,2019nb02029]; China Postdoctoral Science Foundation [2021MD703922]"

基金资助正文："This work was supported by the Chongqing Key Program of Technological Innovation and Application Development (cstc2019jscx-gksbX0064), Research Project of Yongchuan Hospital Affiliated to Chongqing Medical University (YJSJ202135), Public Welfare Science and Technology Projects of Yongchuan District in 2019 (Ycstc,2019nb02029), and China Postdoctoral Science Foundation (2021MD703922)."