Combined effect of ASPECTS and age on outcome of patients with large core infarction treated with mechanical thrombectomy

What research did you initiate to get those mRS scores of 5-6 to improve substantially? Oh, you DID NOTHING? This is why survivors need to be in charge, they are single-mindedly focused on the only goal in stroke: 100% RECOVERY!  If you're not going for that; GET THE HELL OUT OF STROKE!

 Combined effect of ASPECTS and age on outcome of patients with large core infarction treated with mechanical thrombectomy

1. http://orcid.org/0000-0001-7530-674XZibao Li1,
2. Linyu Li2,
3. http://orcid.org/0000-0001-9433-931XZhouzhou Peng2,
4. Shoucai Zhao1,
5. http://orcid.org/0000-0003-2646-982XXianjun Huang1,
6. http://orcid.org/0009-0007-7179-859XShitao Fan2,
7. Xu Xu2,
8. Jinfu Ma2,
9. Chengsong Yue2,
10. Nizhen Yu2,
11. Changwei Guo2,
12. Jie Yang2

1. Correspondence to Dr Jie Yang, Department of Neurology, Army Medical University Xinqiao Hospital, Chongqing 400037, China; yangjie_0929@126.com; Dr Changwei Guo; Changw_Guo@163.com

Abstract

Background Despite the remarkable effectiveness of endovascular treatment (EVT), recent randomized controlled trials indicate that up to half of patients with large core infarction have a very poor outcome (modified Rankin Scale score 5–6 at 90 days). This study investigates the combined effect of Alberta Stroke Program Early CT Score (ASPECTS) and age on very poor outcome in patients with large core infarction treated with EVT.

Methods This subanalysis of the MAGIC registry, which is a prospective, multicenter cohort study of early treatment in acute stroke, focused on patients with ASPECTS ≤5 presenting within 24 hours of stroke onset and receiving CT followed by EVT from November 1, 2021 to February 8, 2023. Multivariable logistic regression was used to investigate the independent and joint association of ASPECTS and age with very poor outcome.

Results Among the 490 patients (57.3% men; median (IQR) age 69 (59–78) years), very poor outcome occurred more frequently in those with lower ASPECTS (65.2% in ASPECTS 0–2 vs 43.4% in ASPECTS 3–5; P<0.001). The predictive value of successful recanalization for very poor outcome was significant in patients with ASPECTS 3–5 (P=0.010), but it diminished in those with ASPECTS 0–2 (P=0.547). Compared with patients with ASPECTS 3–5 and age ≤69 years, the risk of a very poor outcome increased incrementally in those with lower ASPECTS, advanced age, or both (P<0.05). Graphical plot analysis showed a significantly lower probability of very poor outcome in younger patients (≤69 years) compared with older patients (>69 years) across all ASPECTS points.

Conclusion These findings suggest prioritizing young patients as candidates for EVT in those with ASPECTS 0–2.(Oh shit no. All survivors want 100% recovery, not just the young ones that can recover more easily!)

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/jnis-2024-021469

Statistics from Altmetric.com

See more details

Posted by 6 X users

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Request permissions

Data availability statement

Data are available upon reasonable request.

View Full Text