{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T05:53:10Z","timestamp":1775713990363,"version":"3.50.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mechanical thrombectomy (MT) is an established reperfusion therapy for acute ischemic stroke due to large vessel occlusion (LVO-AIS) and has been proven to significantly improve 90-day functional outcomes. However, some patients still experience early neurological deterioration (END) despite successful recanalization. This study aimed to systematically identify independent risk factors for END after MT via retrospective cohort analysis and construct a nomogram by integrating laboratory and clinical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 486 LVO-AIS patients with successful recanalization (eTICI\u22652b) were first categorized as END (\u0394NIHSS\u22654) or non-END (\u0394NIHSS&amp;lt;4) according to the change in the NIHSS score from baseline to 24\u202fh post-procedure. The entire patient group was then randomly divided to obtain training (70%,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f341) and validation (30%,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f145) cohorts. A nomogram was constructed and subsequently validated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We conducted a LASSO regression analysis on the clinical data of the patients in the modelling cohort and identified 6 disease characteristic variables. These variables were subsequently entered into a multivariate logistic regression model, which ultimately retained 5 independent predictors: smoking status (OR\u202f=\u202f3.90, 95% CI 1.760\u20139.681,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002), platelet count (OR\u202f=\u202f1.54, 95% CI 1.129\u20132.130,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.007), systolic blood pressure (SBP) (OR\u202f=\u202f1.80, 95% CI 1.300\u20132.543,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001), puncture-to-recanalization time (PRT) (OR\u202f=\u202f1.57, 95% CI 1.084\u20132.346,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.024), and the neutrophil-to-lymphocyte ratio (NLR) (OR\u202f=\u202f1.86, 95% CI 1.311\u20132.703,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001). The prediction model showed good discriminative performance, with a C-index of 0.803 (95% CI: 0.738\u20130.868;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The area under the ROC curve (AUC) was 0.803 (95% CI 0.738\u20130.868) in the training cohort and 0.799 (95% CI 0.693\u20130.905;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) in the validation cohort. The model also exhibited good calibration. The Hosmer\u2013Lemeshow goodness-of-fit test showed no significant difference between the predicted and observed results (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f3.607,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.891), and the mean absolute error of the calibration curve in the training cohort was 0.169.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The constructed prediction model accurately estimated the risk of END in LVO-AIS patients who underwent MT with successful recanalization and may help optimize patient selection for endovascular therapy and provide reliable prognostic information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1749495","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T05:21:00Z","timestamp":1775712060000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Related factors and a predictive model for early neurological deterioration after mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion"],"prefix":"10.3389","volume":"17","author":[{"given":"Yang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tianjin Medical University","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases","place":["Tianjin, China"]},{"name":"Department of Neurosurgery, Tianjin Huanhu Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyuan","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sifei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Medical University","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases","place":["Tianjin, China"]},{"name":"Department of Neurosurgery, Tianjin Huanhu Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leilei","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Medical University","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases","place":["Tianjin, China"]},{"name":"Department of Neurosurgery, Tianjin Huanhu Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Medical University","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases","place":["Tianjin, China"]},{"name":"Department of Neurosurgery, Tianjin Huanhu Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Medical University","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases","place":["Tianjin, China"]},{"name":"Department of Neurosurgery, Tianjin Huanhu Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/S1474-4422(19)30034-1","article-title":"Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the global burden of disease study 2016","volume":"18","year":"2019","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/S1474-4422(19)30415-6","article-title":"Advances and challenges in stroke rehabilitation","volume":"19","author":"Stinear","year":"2020","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1001\/jama.2020.26867","article-title":"Diagnosis and management of transient ischemic attack and acute ischemic stroke: a review","volume":"325","author":"Mendelson","year":"2021","journal-title":"JAMA"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"204","DOI":"10.4103\/0028-3886.375413","article-title":"Endovascular Thrombectomy in acute ischemic stroke due to large vessel occlusion: current concepts and controversies","volume":"71","author":"Chandra","year":"2023","journal-title":"Neurol India"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"S6","DOI":"10.1212\/WNL.0000000000012781","article-title":"Global epidemiology of stroke and access to acute ischemic stroke interventions","volume":"97","author":"Saini","year":"2021","journal-title":"Neurology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"178","DOI":"10.4103\/bc.bc_35_21","article-title":"Timing is everything: exercise therapy and remote ischemic conditioning for acute ischemic stroke patients","volume":"7","author":"Lee","year":"2021","journal-title":"Brain Circ"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e9068","DOI":"10.1097\/MD.0000000000009068","article-title":"Early neurological deterioration during the acute phase as a predictor of long-term outcome after first-ever ischemic stroke","volume":"96","author":"Geng","year":"2017","journal-title":"Medicine"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"4","DOI":"10.21037\/atm.2019.12.36","article-title":"Association between neurological deterioration and outcomes in patients with stroke","volume":"8","author":"Liu","year":"2020","journal-title":"Ann Transl Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1159\/000447130","article-title":"Outcomes after early neurological deterioration and transitory deterioration in acute ischemic stroke patients","volume":"42","author":"Helleberg","year":"2016","journal-title":"Cerebrovasc Dis"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1096\/fj.02-0752rev","article-title":"Oxidative DNA damage: mechanisms, mutation, and disease","volume":"17","author":"Cooke","year":"2003","journal-title":"FASEB J"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/00004647-200404000-00001","article-title":"Cerebral ischemia and reperfusion: the pathophysiologic concept as a basis for clinical therapy","volume":"24","author":"Schaller","year":"2004","journal-title":"J Cereb Blood Flow Metab"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1111\/j.1471-4159.2012.07950.x","article-title":"Post-ischemic vascular adhesion protein-1 inhibition provides neuro protection in a rat temporary middle cerebral artery occlusion model","volume":"123","author":"Watcharotayangul","year":"2012","journal-title":"J Neurochem"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"7554","DOI":"10.3390\/ijms21207554","article-title":"Roadmap for stroke: challenging the role of the neuronal extracellular matrix","volume":"21","author":"De Luca","year":"2020","journal-title":"Int J Mol Sci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1159\/000518570","article-title":"Biomarkers in the prediction of hemorrhagic transformation in acute stroke: a systematic review and meta-analysis","volume":"51","author":"Krishnamoorthy","year":"2022","journal-title":"Cerebrovasc D is"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.jocn.2018.09.014","article-title":"Predictive value of plasma matrix metalloproteinase-9 concentrations for spontaneous haemorrhagic transformation in patients with acute ischaemic stroke: a cohort study in Chinese patients","volume":"58","author":"Yuan","year":"2018","journal-title":"J Clin Neurosci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1111\/j.1749-6632.2010.05735","article-title":"NF- \u03baB and innate immunity in ischemic stroke","volume":"1207","author":"Harari","year":"2010","journal-title":"Ann N Y Acad Sci"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"197","DOI":"10.2119\/molmed.2014.00199","article-title":"Acetylbritannilactone modulates microRN A-155-mediated inflammatory response in ischemic cerebral tissues","volume":"21","author":"Wen","year":"2015","journal-title":"Mol Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e01426","DOI":"10.1002\/brb3.1426","article-title":"Neutrophil-lymphocyte ratio predicts post-thrombolysis early neurological deterioration in acute ischemic stroke patients","volume":"9","author":"Gong","year":"2019","journal-title":"Brain Behav"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1159\/00048940","article-title":"Neutrophil-lymphocyte ratio predicts functional and safety outcomes after endovascular treatment for acute ischemic stroke","volume":"45","author":"Duan","year":"2018","journal-title":"Cerebrovasc Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1007\/s00380-011-0214-5","article-title":"Matrix metalloprotein-9 activation under cell-to-cell interaction between endothelial cells and monocytes:possible role of hypoxia and tumor necrosis factor-\u03b1","volume":"27","author":"Yamamoto","year":"2012","journal-title":"Heart Vessel"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.ijcard.2015.03.114","article-title":"Association between neutrophil to lymphocyte ratio and atrial fibrillation","volume":"187","author":"Li","year":"2015","journal-title":"Int J Cardiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1 7350","DOI":"10.1523\/JNEUROSCI.4901-12.2013","article-title":"Boosting regulatory T cells limits neuroinflammation in permanent cortical stroke","volume":"33","author":"Liesz","year":"2013","journal-title":"J Neurosci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e13230","DOI":"10.1111\/eci.13230","article-title":"Systemic immune\u2010inflammation index (SII) predicted clinical outcome in patients with coronary artery disease","volume":"50","author":"Yang","year":"2020","journal-title":"Eur J Clin Investig"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"104340","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.104340","article-title":"Baseline neutrophil counts and neutrophil ratio may predict a poor clinical outcome in minor stroke patients with.Intravenous thrombolysis","volume":"28","author":"Liu","year":"2019","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"670730","DOI":"10.3389\/fneur.2021.670730","article-title":"Relationships between D-dimer levels and stroke risk as well as adverse clinical outcomes after acute ischemic stroke or transient ischemic attack: a systematic review and meta-analysis","volume":"12","author":"Yuan","year":"2021","journal-title":"Front Neurol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1161\/STROKEAHA.108.539429","article-title":"Inflammatory and hemostatic biomarkers associated with early recurrent ischemic lesions in acute ischemic stroke","volume":"40","author":"Kang","year":"2009","journal-title":"Stroke"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1909","DOI":"10.1007\/s00270-018-2022-0","article-title":"Impact of retriever passes on efficacy and safety outcomes of acute ischemic stroke treated with mechanical thrombectomy","volume":"41","author":"Bai","year":"2018","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2482","DOI":"10.1056\/NEJMra071014","article-title":"Platelet activation and atherothrombosis","volume":"357","author":"Dav\u00ec","year":"2007","journal-title":"N Engl J Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"14545","DOI":"10.3390\/ijms232314545","article-title":"Pharmacological actions of 5-hydroxyindolin-2 on modulation of platelet functions and thrombus formation via thromboxane A2 inhibition and cAMP production","volume":"23","author":"Kwon","year":"2022","journal-title":"Int J Mol Sci"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"190","DOI":"10.3390\/life12020190","article-title":"PCSK9 promotes cardiovascular diseases: recent evidence about its association with platelet activation -induced myocardial infarction","volume":"12","author":"Puteri","year":"2022","journal-title":"Life"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.thromres.2015.05.003","article-title":"Mean platelet volume is a predictor of ST resolution following thrombolysis in acute ST elevation myocardial infarction","volume":"136","author":"Ghaffari","year":"2015","journal-title":"Thromb Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"906074","DOI":"10.3389\/fsurg.2022.906074","article-title":"Expression and predictive value of serum NLR, PLR combined with SAA in patients with different stages of colorectal Cancer","volume":"9","author":"Yang","year":"2022","journal-title":"Front Surg"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1255476","DOI":"10.3389\/fneur.2023.1255476","article-title":"A nomogram predicts early neurological deterioration after mechanical thrombectomy in patients with ischemic stroke","volume":"14","author":"Wu","year":"2023","journal-title":"Front Neurol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1136\/neurintsurg-2018-014576","article-title":"Impact of procedural time on clinical and angiographic outcomes in patients with acute ischemic stroke receiving endovascular treatment","volume":"11","author":"Hassan","year":"2019","journal-title":"J Neurointerv Surg"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1136\/neurintsurg-2013-010726","article-title":"The golden hour of stroke intervention: effect of thrombectomy procedural time in acute ischemic stroke on outcome","volume":"6","author":"Spiotta","year":"2014","journal-title":"J Neurointerv Surg"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"120852","DOI":"10.1016\/j.jns.2023.120852","article-title":"Ischemic stroke patients with low DWI ASPECTS scores require puncture to recanalization within 30 min for large vessel occlusion","volume":"454","author":"Yoshie","year":"2023","journal-title":"J Neurol Sci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"2943","DOI":"10.1161\/STROKEAHA.120.029494","article-title":"Predictors of unexplained early neurological deterioration after endovascular treatment for acute ischemic stroke","volume":"51","author":"Girot","year":"2020","journal-title":"Stroke"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"5325","DOI":"10.2147\/IJGM.S472316","article-title":"Neutrophil lymphocyte ratio predicts early neurological deterioration in patients with anterior circulation stroke","volume":"17","author":"Zhao","year":"2024","journal-title":"Int J Gen Med"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1749495\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T05:21:01Z","timestamp":1775712061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1749495\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":38,"alternative-id":["10.3389\/fneur.2026.1749495"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1749495","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]},"article-number":"1749495"}}