Saturday, April 16, 2022

Pre-treatment lesional volume in older stroke patients treated with endovascular treatment

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

First Published February 28, 2022 Research Article 

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.

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.

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.

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?)

Pre-treatment lesional volume might contribute, in association with other relevant clinical features, to the selection of older stroke patients who will benefit from EVT.

 

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