ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1630773
Predicting 28-Day Mortality for Patients with Acute Anterior Circulation Large Vessel Occlusion Stroke following Endovascular Treatment in Neurology Intensive Care Units
Provisionally accepted
- Xiangyang Central Hospital, Xiangyang, China
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Background: The clinical utility of the National Institutes of Health Stroke Scale, Glasgow Coma Scale, and modified Rankin Scale scores in predicting prognosis is well established. However, whether the Acute Physiology and Chronic Health Evaluation System II (APACHE II) score can predict mortality in patients with large vessel occlusion stroke (LVOS) admitted to the neurology intensive care unit (NICU) following endovascular treatment (EVT) remains unclear. This study aims to evaluate the ability of the APACHE II score to predict mortality in post-EVT LVOS patients admitted to the NICU. Methods: This retrospective cohort study enrolled 93 consecutive patients (65 males; mean age, 68.0 years) with acute anterior circulation LVOS who underwent EVT. Patients were categorized intosurvival and death groups based on their 28-day post-EVT survival status. APACHE II scores of the two groups were compared. Receiver operating characteristic (ROC) curve analysis was employed to assess the sensitivity, specificity, and optimal threshold of APACHE II scores in predicting mortality.Model calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test. Multivariable logistic regression was performed to estimate odds ratios (ORs) for mortality prediction.Results: Of the 93 enrolled patients, 74 (79.6%) survived and 19 (20.4%) died within 28 days. The death group had significantly higher APACHE II scores than the survival group [(21.84±4.10) points vs (13.05±5.54) points, P<0.001]. ROC analysis revealed excellent discriminative capacity (AUC
Keywords: APACHE II, large vessel occlusion stroke, endovascular treatment, Intensive Care Unit, Mortality
Received: 18 May 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Wenjing, Chengcheng, Jing, Mei, Chang and Yanhan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhu Yanhan, Xiangyang Central Hospital, Xiangyang, China
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