DOAJ Open Access 2022

Predictors of mortality in acute ischemic stroke treated with endovascular thrombectomy despite successful reperfusion: subgroup analysis of a multicentre randomised clinical trial

Rui Zhao Lei Zhang Yongjun Wang Changchun Jiang Yi Xu +67 lainnya

Abstrak

Objectives We sought to determine the predictors of 90-day mortality despite successful reperfusion.Design Subgroup analysis of a multicentre randomised clinical trial (ClinicalTrials.gov Identifier: NCT03469206).Setting This study used data from the Direct Intra-arterial thrombectomy in order to Revascularize AIS patients with large vessel occlusion Efficiently in Chinese Tertiary hospitals: a Multicenter randomized clinical Trial (DIRECT-MT).Participants 622 patients enrolled in DIRECT-MT.Results Overall successful reperfusion rate was 82.0% (510/622), and 18.5% (115/622) of patients died within 90 days. Univariate analysis identified increased risks of mortality for age ≥70 years, history of diabetes mellitus, National Institutes of Health Stroke Scale (NIHSS) score on admission ≥17, NIHSS score after thrombectomy (24±6 hours) ≥11, Alberta Stroke Program Early Computed Tomography Score (ASPECTS) <9, glucose level at hospital arrival ≥130 mg/dL, location of internal carotid artery occlusion, embolisation into a new territory, symptomatic intracranial haemorrhage (ICH) and a decreased risk of mortality for smoking. In multivariable analysis, smoking (OR 0.38; 95% CI 0.17 to 0.83; p=0.015), NIHSS score on admission ≥17 (OR 3.14; 95% CI 1.77 to 5.55; p<0.001), glucose level at hospital arrival ≥130 mg/dL (OR 2.54; 95% CI 1.51 to 4.27; p<0.001), symptomatic ICH (OR 11.70; 95% CI 4.74 to 28.89; p<0.001) and NIHSS score after thrombectomy (24±6 hours) ≥11 (OR 12.04; 95% CI 5.09 to 28.46; p<0.001) were significant independent predictors of 90-day mortality.Conclusions Symptomatic ICH and high post-thrombectomy NIHSS score are strong predictor of 90-day mortality in acute ischaemic stroke treated with mechanical thrombectomy despite successful reperfusion, as well as high NIHSS score and high glucose level at hospital arrival. However, further studies need to be performed to confirm the association between smoking and mortality.

Topik & Kata Kunci

Medicine

Penulis (72)

Rui Zhao

Lei Zhang

Yongjun Wang

Changchun Jiang

Yi Xu

Mayank Goyal

Hao Wang

Meng Zhang

Fuqiang Guo

Tong Li

Shisheng Ye

Hao Li

Qiang Li

Xiaoxi Zhang

Pengfei Yang

Yibin Fang

Bo Hong

Qinghai Huang

Jianmin Liu

Ya Peng

Wenhuo Chen

Shouchun Wang

Hongchao Shi

Zifu Li

Longde Wang

Min Lou

Tao Wu

Peng Wang

Changming Wen

Xiaofei Ye

Hui Liang

Jie Cao

Sheng Liu

Li Yuan

Tianxiao Li

Huaizhang Shi

Zhi Yang

Hai Chen

Yu Zhou

Jianhui Fu

Qi Fang

Jun Sun

Geng Liao

Liyong Zhang

Yongwei Zhang

Yongxin Zhang

Pengfei Xing

Hongxing Han

Haicheng Yuan

Kaifu Ke

Guoping Wang

Diederik W.J. Dippel

Charles B.L.M. Majoie

Yvo B.W.E.M. Roos

Kilian M. Treurniet

Jiyue Wang

Benqiang Deng

Congguo Yin

Conghui Li

Dianjing Sun

Xincan Yue

Jianhong Yang

Weimin Yang

Hansheng Shu

Jianping Lu

Ling Fang

Jinbo Huang

Weijie Du

Chaomao Li

Laixing Wang

Yansheng Li

Xihua Zhong

Format Sitasi

APA MLA BibTeX

Zhao, R., Zhang, L., Wang, Y., Jiang, C., Xu, Y., Goyal, M. et al. (2022). Predictors of mortality in acute ischemic stroke treated with endovascular thrombectomy despite successful reperfusion: subgroup analysis of a multicentre randomised clinical trial. https://doi.org/10.1136/bmjopen-2021-053765

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Informasi Jurnal

Tahun Terbit: 2022
Sumber Database: DOAJ
DOI: 10.1136/bmjopen-2021-053765
Akses: Open Access ✓