2026 Volume 53 Issue 3 Pages 183-191
Objective: We investigated whether the number of comorbidities at admission is associated with early neurological deterioration (END) in patients with Branch atheromatous disease (BAD).
Methods: We retrospectively analyzed 132 consecutive patients with BAD admitted between April 2014 and November 2022. END was defined as an increase of ≥2 points in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 point in the NIHSS motor subscore within 72 hours of admission. Comorbidity count was defined as the number of chronic conditions under active treatment and/or those observed at admission. Associations were assessed using multivariable logistic regression with missing data handled through multiple imputation (m=20). The results were pooled using Rubin’s rules. The primary model was adjusted for the serum uric acid/serum creatinine ratio, neutrophil-to-lymphocyte ratio, female sex, NIHSS score at admission, and low-density lipoprotein cholesterol. A supplementary analysis used an additionally adjusted model including hypertension, argatroban use, and B-type natriuretic peptide.
Results: END occurred in 52 patients (39.4%). The median comorbidity count was higher in the END group than in the non-END group (2.5 [interquartile range (IQR), 2.0–3.25] vs. 2.0 [IQR, 1.0–3.0]; p=0.004). In the primary model, the comorbidity count was independently associated with END (odds ratio [OR], 1.44; 95% confidence interval [95%CI], 1.08–1.93; p=0.013). In the additionally adjusted model, the comorbidity count remained independently associated with END (adjusted OR, 1.58; 95% CI, 1.13–2.20; p=0.007).
Conclusions: In this single-center retrospective cohort of patients with BAD, a higher comorbidity count at admission was associated with END in multivariable analyses. The prognostic value of comorbidity count should be interpreted cautiously and requires further validation.
