Stroke Treatment Delay Limits Outcome After Mechanical Thrombectomy: Stratification by Arrival Time and ASPECTS
| Autor: | Jeremy Liff, Sun Kim, Cen Zhang, Brent Flusty, Kelley Humbert, Jose Torres, Jeffrey Huang, Thomas Snyder, Seena Dehkharghani, David Gordon, Sara K. Rostanski, Eytan Raz, Aaron Lord, David Turkel-Parrella, Ambooj Tiwari, Matthew Sanger, Erez Nossek, Maksim Shapiro, Jennifer A. Frontera, Shashank Agarwal, Omar Tanweer, Jeffrey Farkas, Erica Scher, Albert Favate, Koto Ishida, Howard A. Riina, Peter Kim Nelson, Shadi Yaghi, Kaitlyn Lillemoe |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Logistic regression Arrival time 030218 nuclear medicine & medical imaging Alberta Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Stroke Aged Ischemic Stroke Retrospective Studies Thrombectomy Aged 80 and over business.industry Retrospective cohort study Odds ratio Middle Aged medicine.disease Confidence interval Outcome (probability) Mechanical thrombectomy Treatment Outcome Reperfusion Cardiology Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of neuroimaging : official journal of the American Society of NeuroimagingReferences. 30(5) |
| ISSN: | 1552-6569 |
| Popis: | BACKGROUND AND PURPOSE Mechanical thrombectomy (MT) has helped many patients achieve functional independence. The effect of time-to-treatment based in specific epochs and as related to Alberta Stroke Program Early CT Score (ASPECTS) has not been established. The goal of the study was to evaluate the association between last known normal (LKN)-to-puncture time and good functional outcome. METHODS We conducted a retrospective cohort study of prospectively collected acute ischemic stroke patients undergoing MT for large vessel occlusion. We used binary logistic regression models adjusted for age, Modified Treatment in Cerebral Ischemia score, initial National Institutes of Health Stroke Scale, and noncontrast CT ASPECTS to assess the association between LKN-to-puncture time and favorable outcome defined as Modified Rankin Score 0-2 on discharge. RESULTS Among 421 patients, 328 were included in analysis. Increased LKN-to-puncture time was associated with decreased probability of good functional outcome (adjusted odds ratio [aOR] ratio per 15-minute delay = .98; 95% confidence interval [CI], .97-.99; P = .001). This was especially true when LKN-puncture time was 0-6 hours (aOR per 15-minute delay = .94; 95% CI, .89-.99; P = .05) or ASPECTS 8-10 (aOR = .98; 95% CI, .97-.99; P = .002) as opposed to when LKN-puncture time was 6-24 hours (aOR per 15-minute delay = .99; 95% CI, .97-1.00; P = .16) and ASPECTS |
| Databáze: | OpenAIRE |
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