The influence factors on good outcome and mortality within 3 months after mechanical thrombectomy in patients with acute large vessel occlusion stroke

  • Nguyen Van Phuong 108 Military Central Hospital

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Abstract

Objective: The influence factors associated with mechanical thrombectomy for patients with acute large vessel occlusion stroke remain to be elucidated. This study aimed to investigate clinical and procedural factors influence on good outcome and mortality after mechanical thrombectomy in a cohort of patients stroke. Subject and method: We analyzed clinical; procedural data and results of 123 patients with acute large vessel occlusion stroke, who had treated mechanical thrombectomy. A good outcome was defined as a modified Rankin Scale (mRS) of 0 to 2 at 3 months. The associations between clinical, imaging, procedural factors and good outcome, mortality, respectively, were evaluated using logistic regression analysis. Result: Using logistic regression analysis, a deviation of the eyes and head (odds ratio {OR}, 1.17; 95% confidence interval {CI}, 1.01 - 1.34, p=0.03); baseline NIHSS score (OR, 1.17; 95% CI: 1.01 - 1.34; p=0.03) and CTA-based collateral flow assessment (OR, 3.35; 95%CI: 0.12 - 0.72; p=0.007) were independent predictors of good outcome. Seizures, Glasgow score < 8, baseline NIHSS score > 15 and ASPECTS < 7 had associated mortality with p<0.01. Revascularization time, reperfusion of cerebral artery (TICI > 2b, 3), ventilation, tracheostomy, craniotomy, reocclusion, symptomatic intracerebral hemorrhage (sICH) after thrombectomy and complication in treated duration were associated with good outcome and mortality. Conclusion: The deviation of the eyes and head, baseline NIHSS score and CTA-based collateral flow were independent predictors of good outcome. Seizures, Glasgow < 8, NIHSS > 15 and ASPECTS < 7 had associated mortality. Revascularization time, reperfusion with TICI > 2a, ventilation, tracheostomy, craniotomy, reocclusion, sICH after thrombectomy and complication were associated with both good outcome and mortality.


Keywords: Acute ischemic stroke, mechanical thrombectomy, prognosis, mortality, outcome.


 

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