Lesional volume makes not one whit of difference in the requirement for 100% recovery for all. My directors never allowed excuses for not performing my work. No excuses are allowed for not getting to 100% recovery. Predicting failure to recover research is fucking stupid.
Pre-treatment lesional volume in older stroke patients treated with endovascular treatment
Abstract
Background:
Recent studies in the general stroke population treated with endovascular treatment (EVT) reported that higher pre-treatment lesional volumes were independently associated with poor neurological outcome and functional dependence after stroke. However, it has been not evaluated in older patients.
Aim:
We test the association between the pre-treatment lesional volume on diffusion-weighted magnetic resonance imaging and relevant outcome measures in older adults with stroke treated with EVT.
Methods:
We included consecutive older adults with stroke (⩾80 years old) treated with EVT in two academic comprehensive stroke centers. The association between pre-treatment lesional volume and relevant outcome measures (poor outcome (modified Rankin scale 4–6), 3-month mortality and symptomatic intracerebral hemorrhage (sICH)) was evaluated using univariate and multivariable models.
Results:
Five
hundred seventy-nine patients were included (mean age: 85.6 ± 4.1,
median lesional volume was 10 ml; interquartile range: 3–30 ml).
Pre-treatment lesional volume was associated with poor functional
outcome (adjusted odds ratio (aOR): 1.87, 95% confidence interval (CI):
1.60–2.20, for +1 logarithmic increase of lesional volume), 3-month
mortality (aOR: 1.50, CI: 1.28–1.76), and sICH (aOR: 1.67, CI:
1.27–2.20). A threshold lesional volume >35 ml predicted 90% of
patients with poor functional outcome and a cut-off >51 ml predicted
90% of patients dead at 3 months.(Do you tell your patients they're going to be dead in 3 months? That you've given up on them?)
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