Deans' stroke musings: Risk factors for early neurological deterioration in patients with acute ischaemic stroke and assessment of short-term prognosis

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, May 26, 2026

Risk factors for early neurological deterioration in patients with acute ischaemic stroke and assessment of short-term prognosis

Totally wrong objective; Survivors actually want early neurological deterioration prevented! 'Assessments' DO NOTHING TOWARDS RECOVERY!

Risk factors for early neurological deterioration in patients with acute ischaemic stroke and assessment of short-term prognosis

Ming Peng *
Y
Yanqing Zhang

Department of Neurology, Sinopharm Tongmei General Hospital, Datong, Shanxi, China

Abstract

Objective:

To identify independent risk factors for early neurological deterioration (END) in patients with acute ischaemic stroke (AIS) and evaluate its impact on short-term clinical outcomes.

Methods:

A total of 186 AIS patients admitted between January 2023 and January 2025 were retrospectively enrolled and divided into an END group (n = 62) and a non-END group (n = 124), based on a NIHSS score increase of ≥2 points within 72 h. Baseline characteristics, laboratory parameters, neuroimaging features, and treatment details were compared. Multivariable logistic regression identified independent risk factors for END and for unfavorable outcomes among END patients. Neurological function was assessed by serial NIHSS scores, and 3-month prognosis by the modified Rankin Scale (mRS).

Results:

The END group showed significantly higher admission NIHSS score, fasting plasma glucose, glycated hemoglobin, homocysteine, high-sensitivity C-reactive protein (hs-CRP), D-dimer, and greater proportions of hypertension, diabetes mellitus, atrial fibrillation, large artery atherosclerosis, cardioembolic subtypes, and large infarction (all P < 0.05). Multivariable analysis identified higher admission NIHSS score, fasting plasma glucose, hs-CRP, D-dimer, atrial fibrillation history, and large infarction as independent risk factors for END. END patients had persistently elevated NIHSS scores, higher rates of unfavorable 3-month outcomes (mRS ≥3), longer hospital stays, and greater mortality (all P < 0.05). Among END patients, admission NIHSS ≥12, large infarction, and hs-CRP ≥15 mg/L independently predicted unfavorable outcomes.

Conclusions:

Higher admission NIHSS score, fasting plasma glucose, hs-CRP, D-dimer, atrial fibrillation, and large infarction are independent risk factors for END in AIS. END is associated with worse neurological recovery, prolonged hospitalization, and higher 3-month mortality. Early identification of high-risk patients and targeted intervention are essential for improving outcomes.