Possibilities of functional outcome prediction in patients with acute ischemic stroke, who did not receive reperfusion therapy

Purpose of the study was to identify potential predictors of functional outcome of patients in the acute period of ischemic stroke, who did not receive reperfusion therapy, based on discriminant analysis. Materials and methods : 193 patients diagnosed with ischemic stroke (IS) in the carotid basin, who did not receive reperfusion therapy, were examined. The evaluation of 35 parameters was used to create a mathematical prediction model: demographic parameters; comorbidity; localization of IS; degree of white matter hyperintensity (WMH); focal size; degree of internal carotid artery stenosis; NIHSS; cognitive status (IQCODE, MoCA, Stroop, Bourdon, Luria tests); severity of motor, sensory and speech impairments, presence of hemineglect; IS subtype; serum concentrations of cytokines IL-1b, IL-16, TNFα, CXCL10, CXCL11, CXCL9, CXCL1, CXCL6, CCL11, CCL24, CCL15, CCL23. Disability scores (modified Rankin Scale, mRS) and severity of cognitive deficit (Dementia Rating Scale, CDR) on day 14 from the development of IS were considered as functional outcome (FO) parameters. The Python programming language and SciPy library were used for statistical processing. Results : the number of patients with unfavorable/ relatively unfavorable outcome at day 14 from the development of IS according to mRS was 51 (26.4%), according to CDR scale — 65 (33.6%) people. Statistical analysis revealed correlations of FO index on the mRS scale with the presence of diabetes mellitus, localization of IS, IL-1b, CCL24 and CCL23 concentrations; on the CDR scale — with the degree of IQCODE, WMH, CXCL10 level, impaired memory, speech and perception functions. Conclusion : perceptual, mnestic and speech disorders along with the presence of premorbid cognitive deficit, WMH, left-sided localization of IS in the middle cerebral artery basin, changes in IL-1b, CCL23, CCL24 and CXCL10 concentrations were identified as independent predictors of adverse functional outcome of the patient in the acute period of ischemic stroke, who did not receive reperfusion therapy.