Mechanical Thrombectomy in Nighttime Hours: Is There a Difference in 90-Day Clinical Outcome for Patients with Ischemic Stroke?
| Autor: | Alain Bonafe, E. Le Bars, François Molino, Jeremy Deverdun, I. Derraz, F. Cagnazzo, Cyril Dargazanli, Isabelle Mourand, Anne Ducros, M. Moynier, Vincent Costalat, N. Menjot de Champfleur, Amel Benali, Caroline Arquizan |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Time Factors medicine.medical_treatment Logistic regression Revascularization 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Admission time Medicine Humans Radiology Nuclear Medicine and imaging Aged Ischemic Stroke Retrospective Studies Thrombectomy Nihss score Aged 80 and over Interventional business.industry Retrospective cohort study Middle Aged Mechanical thrombectomy Treatment Outcome Anesthesia Ischemic stroke Functional independence Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X |
| Popis: | BACKGROUND AND PURPOSE: Few data are available regarding the influence of the timing of ischemic stroke management, such as daytime and nighttime hours, on the delay of mechanical thrombectomy, the effectiveness of revascularization, and clinical outcomes. We aimed to investigate whether admission during nighttime hours could impact the clinical outcome (mRS at 90 days) of patients with acute ischemic stroke treated by mechanical thrombectomy. MATERIALS AND METHODS: We retrospectively analyzed 169 patients (112 treated during daytime hours and 57 treated during nighttime hours) with acute ischemic stroke in the anterior cerebral circulation. The main outcome was the rate of patients achieving functional independence at 90 days (mRS ≤2), depending on admission time. RESULTS: In patients admitted during nighttime hours, the rate of mRS ≤ 2 at 90 days was significantly higher (51% versus 35%, P = .05) compared with those admitted in daytime hours. Patients in daytime and nighttime hours were comparable regarding admission and treatment characteristics. However, patients in nighttime hours tended to have a higher median NIHSS score at admission (P = .08) and to be younger (P = .08), especially among the mothership group (P = .09). The multivariate logistic regression analysis confirmed that patients in nighttime hours had better functional outcomes at 90 days than those in daytime hours (P = .018; 95% CI, 0.064–0.770; OR = 0.221). CONCLUSIONS: In a highly organized stroke care network, mechanical thrombectomy is quite effective in the nighttime hours among acute ischemic stroke presentations. Unexpectedly, we found that those patients achieved favorable clinical outcomes more frequently than those treated during daytime hours. Larger series are needed to confirm these results. |
| Databáze: | OpenAIRE |
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