Functional long-term outcome following endovascular thrombectomy in patients with acute ischemic stroke

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作者
Andreas Rogalewski
Nele Klein
Anja Friedrich
Alkisti Kitsiou
Marie Schäbitz
Frédéric Zuhorn
Burkhard Gess
Björn Berger
Randolf Klingebiel
Wolf-Rüdiger Schäbitz
机构
[1] University Hospital OWL of the University Bielefeld,Department of Neurology, Evangelisches Klinikum Bethel
[2] Catholic Hospital Association of East Westfalia (KHO),Department of Neurology, Sankt Elisabeth Hospital Gütersloh
[3] RWTH Aachen University,Department of Neurology, Medical Faculty
[4] Bielefeld University,Department of Psychology
[5] University Hospital OWL of the University Bielefeld,Department of Neuroradiology, Evangelisches Klinikum Bethel EvKB
关键词
Endovascular treatment; Thrombectomy; Stroke; Large vessel occlusion; Long-term outcome; Modified Rankin Scale; Quality of life; HRQoL;
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摘要
Endovascular thrombectomy (EVT) is the most effective treatment for acute ischemic stroke caused by large vessel occlusion (LVO). Yet, long-term outcome (LTO) and health-related quality of life (HRQoL) in these patients have rarely been addressed, as opposed to modified Rankin scale (mRS) recordings. We analysed demographic data, treatment and neuroimaging parameters in 694 consecutive stroke patients in a maximum care hospital. In 138 of these patients with respect on receipt of written informed consent, LTO and HRQoL were collected over a period of 48 months after EVT using a standardised telephone survey (median 2.1 years after EVT). Age < 70 years (OR 4.82), lower NIHSS on admission (OR 1.11), NIHSS ≤ 10 after 24 h (OR 11.23) and complete recanalisation (mTICI3) (OR 7.79) were identified as independent predictors of favourable LTO. Occurrence of an infection requiring treatment within the first 72 h was recognised as a negative predictor for good long-term outcome (OR 0.22). Patients with mRS > 2 according to the telephone survey more often had complaints regarding mobility, self‐care, and usual activity domains of the HRQoL. Our results underline a sustainable positive effect of effective EVT on the quality of life in LVO stroke. Additionally, predictive parameters of outcome were identified, that may support clinical decision making in LVO stroke.
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