{
  "abstract": "Objective Some patients with large core infarctions who underwent endovascular treatment (EVT) still achieved favorable long-term outcomes despite the absence of neurological improvement in the acute phase. The underlying reasons for this phenomenon remain unclear. This study aimed to investigate the incidence and predictors of delayed neurological improvement (DNI) in this patient population.Methods Patients with large core infarctions who received EVT were derived from a prospective, observational, nationwide multicenter registry. Acute phase neurological improvement (APNI) was defined as a decrease of ≥4 points in the National Institutes of Health Stroke Scale (NIHSS) score between admission and day 5–7. DNI was defined as achieving 90-day favorable outcomes in the absence of APNI. Multivariate logistic regression was used to analyze independent predictors of DNI.Results Among 490 patients with large core infarctions who underwent EVT, 277 (56.5%) did not experience APNI. Of these, 39 (14.1%) patients achieved favorable long-term clinical outcomes and constituted the DNI group. Younger age, male sex, lower baseline NIHSS score, good collateral circulation, and shorter puncture to reperfusion time were independent predictors of DNI.Conclusion DNI occurred in 14.1% of patients with large core infarctions undergoing EVT. Optimizing modifiable factors, such as reducing puncture to reperfusion time and improving collateral circulation, is crucial for enhancing patient outcomes. These findings have important implications for refining clinical management strategies and improving prognosis in this patient population.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu, China"
      ],
      "name": "Miao Chai"
    },
    {
      "affiliations": [
        "Department of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu, China"
      ],
      "name": "Xiaolei Gong"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Min Li"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Linyu Li"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Changwei Guo"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Jie Yang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Guojian Liu"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Lilan Wang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Xiaolei Shi"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Shihai Yang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Jinfu Ma"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Xu Xu"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Dahong Yang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Wenzhe Sun"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Shitao Fan"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Jiaxing Song"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China"
      ],
      "name": "Wenjie Zi"
    },
    {
      "affiliations": [
        "Department of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu, China"
      ],
      "name": "Zhenchang Zhang"
    }
  ],
  "title": "Predictors of delayed neurological improvement in patients with large core infarctions undergoing endovascular treatment",
  "uid": "d39571d8-593b-5187-986f-8bf1747eaaa1"
}