Factors Associated with Poor Outcomes in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke due to Large-Vessel Occlusion in Acute Anterior Circulation: A Retrospective Study

Leaders would solve this problem, not just ask the question. But we have NO LEADERSHIP IN STROKE, and never will until survivors are in charge.  You notice they are not even measuring the correct goal, 100% recovery, just the intermediate goal of reperfusion.

Factors Associated with Poor Outcomes in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke due to Large-Vessel Occlusion in Acute Anterior Circulation: A Retrospective Study

Author links open overlay panelYi-HeZhangM.D.^a&Ming-ChaoShiM.D., Ph.D.^a&Zhong-XiuWangPh.D.^aChaoLiM.D., Ph.D.^aMeng-YaoSunM.D.^bJieZhouM.D.^aWen-BinZhangM.D.^aLong-WenHuoM.D.^aShou-ChunWangM.D., Ph.D.^a

^a

Department of Neurology, the First Hospital of Jilin University, Changchun, China;

^b

Department of Ultrasound, the First Hospital of Jilin University, Changchun, China;

Received 2 January 2021, Revised 12 February 2021, Accepted 13 February 2021, Available online 20 February 2021.

https://doi.org/10.1016/j.wneu.2021.02.064Get rights and content

Abstract

Objective

To investigate factors associated with poor clinical outcomes in patients with acute ischemic stroke (AIS) undergoing endovascular therapy.

Methods

A retrospective review of 265 patients with AIS treated in the First Hospital of Jilin University between January 1, 2016 and November 1, 2019 was performed. The primary outcome was the proportion of patients with a modified Rankin score of 0–2 at 90 days. Univariate and multivariate analyses were performed to assess potential clinical factors associated with a poor 90-day outcome.

Results

The rates of successful revascularization,(NOT GOOD ENOUGH!) good prognosis, symptomatic intracranial hemorrhage (sICH), and mortality were 84.5%, 46.0%, 9.8%, and 12.8%, respectively. As per univariate analysis, age, diagnosis of atrial fibrillation, diagnosis of diabetes, high baseline glucose level, tandem occlusion, high National Institutes of Health Stroke Scale (NIHSS) score at admission, general anesthesia, number of passes, high NIHSS score on discharge, unsuccessful recanalization (modified treatment in cerebral ischemia [mTICI] score <2b), and development of sICH, hemorrhagic infarction, parenchymal hematoma, and subarachnoid hemorrhage were associated with poor prognosis. Tobacco use was positive in correlation with good prognosis in univariate analysis. Diabetes, tandem occlusion, high NIHSS score at admission, and general anesthesia were independent factors associated with poor 90-day outcome in multivariate analysis.

Conclusions

Diabetes, tandem occlusion, high NIHSS score at admission, and general anesthesia were independent risk factors associated with a poor 90-day outcome and should be considered a reference by neurointerventionalists in guiding their clinical decision-making.