You tell us rescue of language impairment among LHS patients was associated with functional independence (P=0.02) and lower mortality (P=0.001) but give us no protocols for that rescue. Worthless. Damn it all, stroke research is to get survivors recovered and there is no way survivors can use this research to get recovered.
Rescue of Neglect and Language Impairment After Stroke Thrombectomy
Originally published16 Jul 2021https://doi.org/10.1161/STROKEAHA.121.034243Stroke. ;0:STROKEAHA.121.034243Abstract
BACKGROUND AND PURPOSE:
Although
National Institutes of Health Stroke Scale scores provide an objective
measure(Really? You have never actually looked at it? You still don't know that the NIHSS subjective stroke scale is worthless?)
of clinical deficits, data regarding the impact of neglect or
language impairment on outcomes after mechanical thrombectomy (MT) is
lacking. We assessed the frequency of neglect and language impairment,
rate of their rescue by MT, and impact of rescue on clinical outcomes.
Methods:
This
is a retrospective analysis of a prospectively collected database from a
comprehensive stroke center. We assessed right (RHS) and left
hemispheric strokes (LHS) patients with anterior circulation large
vessel occlusion undergoing MT to assess the impact of neglect and
language impairment on clinical outcomes, respectively. Safety and
efficacy outcomes were compared between patients with and without rescue
of neglect or language impairment.
Results:
Among
324 RHS and 210 LHS patients, 71% of patients presented with neglect
whereas 93% of patients had language impairment, respectively. Mean age
was 71±15, 56% were females, and median National Institutes of Health
Stroke Scale score was 16 (12–20). At 24 hours, MT resulted in rescue of
neglect in 31% of RHS and rescue of language impairment in 23% of LHS
patients, respectively. RHS patients with rescue of neglect (56% versus
34%, P<0.001) and LHS patients with rescue of language impairment (64 % versus 25%, P<0.01)
were observed to have a higher rate of functional independence compared
to patients without rescue. After adjusting for confounders including
24-hour National Institutes of Health Stroke Scale, rescue of neglect
among RHS patients was associated with functional independence (P=0.01) and lower mortality (P=0.01). Similarly, rescue of language impairment among LHS patients was associated with functional independence (P=0.02) and lower mortality (P=0.001).
ConclusionS:
Majority
of LHS-anterior circulation large vessel occlusion and of RHS-anterior
circulation large vessel occlusion patients present with the impairment
of language and neglect, respectively. In comparison to 24-hour National
Institutes of Health Stroke Scale, rescue of these deficits by MT is an
independent and a better predictor of functional independence and lower
mortality.
Abstract
BACKGROUND AND PURPOSE:
Although National Institutes of Health Stroke Scale scores provide an objective measure(Really? You have never actually looked at it? You still don't know that the NIHSS subjective stroke scale is worthless?)
of clinical deficits, data regarding the impact of neglect or language impairment on outcomes after mechanical thrombectomy (MT) is lacking. We assessed the frequency of neglect and language impairment, rate of their rescue by MT, and impact of rescue on clinical outcomes.
Methods:
This is a retrospective analysis of a prospectively collected database from a comprehensive stroke center. We assessed right (RHS) and left hemispheric strokes (LHS) patients with anterior circulation large vessel occlusion undergoing MT to assess the impact of neglect and language impairment on clinical outcomes, respectively. Safety and efficacy outcomes were compared between patients with and without rescue of neglect or language impairment.
Results:
Among 324 RHS and 210 LHS patients, 71% of patients presented with neglect whereas 93% of patients had language impairment, respectively. Mean age was 71±15, 56% were females, and median National Institutes of Health Stroke Scale score was 16 (12–20). At 24 hours, MT resulted in rescue of neglect in 31% of RHS and rescue of language impairment in 23% of LHS patients, respectively. RHS patients with rescue of neglect (56% versus 34%, P<0.001) and LHS patients with rescue of language impairment (64 % versus 25%, P<0.01) were observed to have a higher rate of functional independence compared to patients without rescue. After adjusting for confounders including 24-hour National Institutes of Health Stroke Scale, rescue of neglect among RHS patients was associated with functional independence (P=0.01) and lower mortality (P=0.01). Similarly, rescue of language impairment among LHS patients was associated with functional independence (P=0.02) and lower mortality (P=0.001).
ConclusionS:
Majority of LHS-anterior circulation large vessel occlusion and of RHS-anterior circulation large vessel occlusion patients present with the impairment of language and neglect, respectively. In comparison to 24-hour National Institutes of Health Stroke Scale, rescue of these deficits by MT is an independent and a better predictor of functional independence and lower mortality.
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