Mortality after large artery occlusion acute ischemic stroke

Abstract Despite randomized trials showing a functional outcome benefit in favor of endovascular therapy (EVT), large artery occlusion acute ischemic stroke is associated with high mortality. We performed a retrospective analysis from a prospectively collected code stroke registry and included patie...

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Autores principales:	Rahul R. Karamchandani, Jeremy B. Rhoten, Dale Strong, Brenda Chang, Andrew W. Asimos
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/28399706e9bc47af85303b2a0b50e980
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spelling	oai:doaj.org-article:28399706e9bc47af85303b2a0b50e9802021-12-02T15:36:14ZMortality after large artery occlusion acute ischemic stroke10.1038/s41598-021-89638-x2045-2322https://doaj.org/article/28399706e9bc47af85303b2a0b50e9802021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89638-xhttps://doaj.org/toc/2045-2322Abstract Despite randomized trials showing a functional outcome benefit in favor of endovascular therapy (EVT), large artery occlusion acute ischemic stroke is associated with high mortality. We performed a retrospective analysis from a prospectively collected code stroke registry and included patients presenting between November 2016 and April 2019 with internal carotid artery and/or proximal middle cerebral artery occlusions. Ninety-day mortality status from registry follow-up was corroborated with the Social Security Death Index. A multivariable logistic regression model was fitted to determine demographic and clinical characteristics associated with 90-day mortality. Among 764 patients, mortality rate was 26%. Increasing age (per 10 years, OR 1.48, 95% CI 1.25–1.76; p < 0.0001), higher presenting NIHSS (per 1 point, OR 1.05, 95% CI 1.01–1.09, p = 0.01), and higher discharge modified Rankin Score (per 1 point, OR 4.27, 95% CI 3.25–5.59, p < 0.0001) were independently associated with higher odds of mortality. Good revascularization therapy, compared to no EVT, was independently associated with a survival benefit (OR 0.61, 95% CI 0.35–1.00, p = 0.048). We identified factors independently associated with mortality in a highly lethal form of stroke which can be used in clinical decision-making, prognostication, and in planning future studies.Rahul R. KaramchandaniJeremy B. RhotenDale StrongBrenda ChangAndrew W. AsimosNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rahul R. Karamchandani Jeremy B. Rhoten Dale Strong Brenda Chang Andrew W. Asimos Mortality after large artery occlusion acute ischemic stroke
description	Abstract Despite randomized trials showing a functional outcome benefit in favor of endovascular therapy (EVT), large artery occlusion acute ischemic stroke is associated with high mortality. We performed a retrospective analysis from a prospectively collected code stroke registry and included patients presenting between November 2016 and April 2019 with internal carotid artery and/or proximal middle cerebral artery occlusions. Ninety-day mortality status from registry follow-up was corroborated with the Social Security Death Index. A multivariable logistic regression model was fitted to determine demographic and clinical characteristics associated with 90-day mortality. Among 764 patients, mortality rate was 26%. Increasing age (per 10 years, OR 1.48, 95% CI 1.25–1.76; p < 0.0001), higher presenting NIHSS (per 1 point, OR 1.05, 95% CI 1.01–1.09, p = 0.01), and higher discharge modified Rankin Score (per 1 point, OR 4.27, 95% CI 3.25–5.59, p < 0.0001) were independently associated with higher odds of mortality. Good revascularization therapy, compared to no EVT, was independently associated with a survival benefit (OR 0.61, 95% CI 0.35–1.00, p = 0.048). We identified factors independently associated with mortality in a highly lethal form of stroke which can be used in clinical decision-making, prognostication, and in planning future studies.
format	article
author	Rahul R. Karamchandani Jeremy B. Rhoten Dale Strong Brenda Chang Andrew W. Asimos
author_facet	Rahul R. Karamchandani Jeremy B. Rhoten Dale Strong Brenda Chang Andrew W. Asimos
author_sort	Rahul R. Karamchandani
title	Mortality after large artery occlusion acute ischemic stroke
title_short	Mortality after large artery occlusion acute ischemic stroke
title_full	Mortality after large artery occlusion acute ischemic stroke
title_fullStr	Mortality after large artery occlusion acute ischemic stroke
title_full_unstemmed	Mortality after large artery occlusion acute ischemic stroke
title_sort	mortality after large artery occlusion acute ischemic stroke
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/28399706e9bc47af85303b2a0b50e980
work_keys_str_mv	AT rahulrkaramchandani mortalityafterlargearteryocclusionacuteischemicstroke AT jeremybrhoten mortalityafterlargearteryocclusionacuteischemicstroke AT dalestrong mortalityafterlargearteryocclusionacuteischemicstroke AT brendachang mortalityafterlargearteryocclusionacuteischemicstroke AT andrewwasimos mortalityafterlargearteryocclusionacuteischemicstroke
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Mortality after large artery occlusion acute ischemic stroke

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