Risk factors analysis and nursing measures of early neurological deterioration in patients with acute ischemic stroke

ObjectiveTo explore the related risk factors and nursing measures of early neurological deterioration (END) in patients with acute ischemic stroke (AIS).

MethodsFour hundred and two patients with AIS from 2014 to 2017 were divided into the END group (68 cases with NIHSS score increasing by 2 or more within 7 days after onset) and non-END group (334 cases).The clinical data between two groups were compared using the univariate analysis, and the independent risk factor of END was analyzed using the logistic regression analysis.

ResultsThe differences of the body temperature, history of atrial fibrillation, carotid artery stenosis, baseline NIHSS score, hyperglycemia, homocysteine, C reactive protein and white blood cell between two groups were statistically significant (P < 0.01). The results of multivariate logistic regression analysis showed that the carotid artery stenosis ≥ 50% (OR=2.483, 95%CI:1.020 to 6.044), high baseline NIHSS score (OR=1.219, 95%CI:1.135 to 1.310), high blood glucose (OR=1.101, 95%CI:1.009 to 1.202), high C reactive protein (OR=1.029, 95%CI:1.007 to 1.052) and high white blood cell level (OR=1.172, 95%CI:1.042 to 1.319) were the independent risk factors of END.

ConclusionsThe more stenosis the carotid artery, higher the baseline NIHSS score, and higher the levels of blood glucose, C reactive protein and white blood cell, the greater the risk of END.The results can provide reference for clinical nurses to assess the condition of patients with AIS, and set individualized treatment and nursing measures.