Abstract
AIMS/BACKGROUND
Early neurological deterioration (END) after thrombolysis is a serious complication in acute ischemic stroke (AIS); however, its early identification remains challenging. This study aimed to investigate the value of amplitude-integrated electroencephalography (aEEG) combined with CD4+/CD8+ ratio in assessing END in patients with AIS.
METHODS
The study enrolled 210 AIS patients who underwent thrombolysis at Shangyu People's Hospital of Shaoxing, China, between May 2020 and May 2025. Based on whether the National Institutes of Health Stroke Scale (NIHSS) score at 24 hours post-thrombolysis increased by ≥4 points compared to the score at admission, patients were divided into an END group (score increase ≥4, n = 61) and a non-END group (score increase <4, n = 149). Clinical data were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the aEEG score and CD4+/CD8+ ratio, both individually and in combination, for END after thrombolysis. Multivariate logistic regression analysis was performed to identify factors influencing END post-thrombolysis. Furthermore, two predictive models were constructed and their predictive efficacy evaluated: Model 1 (excluding aEEG score and CD4+/CD8+ ratio) and Model 2 (including aEEG score and CD4+/CD8+ ratio).
RESULTS
The onset-to-needle time in the END group was significantly longer than in the non-END group. NIHSS score at admission, white blood cell count (WBC), Systemic Inflammation Response Index (SIRI), and aEEG score were significantly higher in the END group, while the CD4+/CD8+ ratio was significantly lower ( p p p = 0.856 and 0.997, respectively), with AUCs of 0.944 and 0.991. In Model 2, the variance inflation factor (VIF) for all six influencing factors ranged from 1.070 to 1.383.
CONCLUSION
The aEEG score and the CD4+/CD8+ ratio have a significant influence on the occurrence of END in AIS patients after thrombolysis, and their combination improves predictive performance.