医学
改良兰金量表
优势比
倾向得分匹配
冲程(发动机)
探索性分析
可能性
麻醉
镇静
入射(几何)
多元分析
内科学
缺血性中风
逻辑回归
缺血
数据科学
工程类
物理
光学
机械工程
计算机科学
作者
Xinyan Wang,Fa Liang,Yin Wu,Baixue Jia,Zhang Xiao-li,Minyu Jian,Haiyang Liu,Anxin Wang,Zhongrong Miao,Ruquan Han
出处
期刊:Journal of Neurosurgical Anesthesiology
[Ovid Technologies (Wolters Kluwer)]
日期:2024-03-28
标识
DOI:10.1097/ana.0000000000000959
摘要
Data on the impact of different anesthesia methods on clinical outcomes in patients with acute ischemic stroke undergoing endovascular therapy (EVT) in extended windows are limited. This study compared clinical outcomes in patients with stroke having general anesthesia (GA), conscious sedation (CS), or local anesthesia (LA) during EVT in extended (>6 h) time windows.We conducted an exploratory analysis of data from the ANGEL-ACT registry. The primary outcome was the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included the proportions of patients with mRS scores of 0 to 1, 0 to 2, and 0 to 3, and safety outcomes were any intracranial hemorrhage (ICH), symptomatic ICH, or mortality within 90 days. Multivariate analyses, inverse probability of treatment weighting, and coarsened exact matching were used to adjust for indication bias.A total of 646 patients were included in the analysis (GA,280; CS, 103; LA, 263). Patients having LA during EVT were more likely to have a favorable mRS score (adjusted odds ratio [aOR]: 1.75; 95% CI: 1.28 to 2.40) and a lower incidence of symptomatic ICH (aOR: 0.33; 95% CI: 0.14 to 0.76) than those having GA group. Similarly, CS was associated with greater odds of favorable 90-day mRS scores compared with GA (aOR: 1.69; 95% CI: 1.11 to 2.56). Posterior circulation stroke was overrepresented in the GA group (29.6%) and may be a reason for the worse outcomes in the GA group.Patients who received LA or CS had better neurological outcomes than those who received GA within extended time windows in a real-world setting.
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