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Research ArticleNeurointervention

Clinical Outcome after Thrombectomy in Patients with Stroke with Premorbid Modified Rankin Scale Scores of 3 and 4: A Cohort Study with 136 Patients

F. Seker, J. Pfaff, S. Schönenberger, C. Herweh, S. Nagel, P.A. Ringleb, M. Bendszus and M.A. Möhlenbruch
American Journal of Neuroradiology February 2019, 40 (2) 283-286; DOI: https://doi.org/10.3174/ajnr.A5920

Article Figures & Data

Tables

  • Table 1:

    Modified Rankin Scale

    ScoreDescription
    0No symptoms at all
    1No significant disability despite symptoms: able to carry out all usual duties and activities
    2Slight disability: unable to carry out all previous activities, but able to look after own affairs without assistance
    3Moderate disability: requiring some help, but able to walk without assistance
    4Moderately severe disability: unable to walk without assistance and unable to attend own bodily needs without assistance
    5Severe disability: bedridden, incontinent, and requiring constant nursing care and attention
    6Death

    • Originally published in van Swieten J, Koudstaal P, Visser M, et al. “Interobserver agreement for the assessment of handicap in stroke patients.” Stroke 1988;19:604-07.

  • Table 2:

    Patient characteristics

    Total (n = 136)Good Outcome (n = 29)Poor Outcome (n = 107)P Valuea
    Age (mean) (SD)80.6 (10.1)79.5 (13.2)81.0 (9.2).585
    Female (No.) (%)90 (66.2)20 (69.0)70 (65.4).827
    Diabetes (No.) (%)34 (25.0)5 (17.2)29 (27.1).340
    Hypertension (No.) (%)102 (75.0)21 (72.4)81 (75.7).809
    Arrhythmia (No.) (%)84 (61.8)19 (65.5)65 (60.7).674
    Coronary heart disease (No.) (%)41 (30.1)8 (27.6)33 (30.8).822
    Hypercholesterolemia (No.) (%)41 (30.1)8 (27.6)33 (30.8).822
    Premorbid mRS (No.) (%).719
        3111 (81.6)23 (79.3)88 (82.2)
        425 (18.4)6 (20.7)19 (17.8)
    Baseline NIHSS (median) (IQR)18 (15–22)15 (12–19)19 (15–23).009
    ASPECTS (median) (IQR)9 (8–10)10 (9–10)9 (8–10).051
    Intravenous thrombolysis (No.) (%)61 (44.9)13 (44.8)48 (44.9)1.000
    Onset-to-groin (median) (IQR)240 (180–344)232 (182–280)247 (180–357).250
    Groin-to-TICI (median) (IQR)75 (41–108)63 (32–97)77 (46–117).142
    Occlusion site (No.) (%)
        ICA31 (22.8)2 (6.9)29 (27.1).024
        M178 (57.4)15 (51.7)63 (58.9).530
        M230 (22.1)12 (41.4)18 (16.8).010
    TICI 2b–3103 (75.7)27 (93.1)76 (71.0).014

    • Note:—IQR indicates interquartile range.

    • ↵a Comparison between patients with good and poor outcomes.

  • Table 3:

    Multivariate analysis—independent predictors of good outcome

    Odds Ratio (95% CI)Adjusted P Value
    Baseline NIHSS0.92 (0.85–0.99).040
    ASPECTS1.45 (1.02–2.16).049
    ICA occlusion0.31 (0.04–1.30).152
    M2 occlusion2.35 (0.86–6.52).097
    TICI 2b–37.11 (1.73–49.90).017
  • Table 4:

    Comparison of outcome in patients with premorbid mRS 3 and 4

    Premorbid mRS 3 (n = 111)Premorbid mRS 4 (n = 25)P Value
    TICI 2b–3 (No.) (%)85 (76.6)18 (72.0).614
    90-Day mRS (median) (IQR)5 (3.5–6)6 (4–6)<.001
    Good outcome (No.) (%)23 (20.7)6 (24.0).788
    Hospital mortality (No.) (%)17 (15.3)6 (24.0).231
    Mortality at 90 days (No.) (%)52 (46.8)16 (64.0).183
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Clinical Outcome after Thrombectomy in Patients with Stroke with Premorbid Modified Rankin Scale Scores of 3 and 4: A Cohort Study with 136 Patients
F. Seker, J. Pfaff, S. Schönenberger, C. Herweh, S. Nagel, P.A. Ringleb, M. Bendszus, M.A. Möhlenbruch
American Journal of Neuroradiology Feb 2019, 40 (2) 283-286; DOI: 10.3174/ajnr.A5920
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