Predictors and outcome of early neurological deterioration after endovascular thrombectomy: a secondary analysis of the DIRECT-MT trial

医学 改良兰金量表 冲程(发动机) 逻辑回归 血管内治疗 闭塞 腹股沟 随机对照试验 内科学 外科 缺血性中风 动脉瘤 缺血 机械工程 工程类
作者
Miaoyi Zhang,Pengfei Xing,Jie Tang,Langfeng Shi,Pengfei Yang,Yongwei Zhang,Lei Zhang,Ya Peng,Sheng Liu,Liyong Zhang,Jianhui Fu,Jianmin Liu
出处
期刊:Journal of NeuroInterventional Surgery [BMJ]
卷期号:15 (e1): e9-e16 被引量:16
标识
DOI:10.1136/neurintsurg-2022-018976
摘要

There is uncertainty regarding the predictors of early neurological deterioration (END) after endovascular thrombectomy in patients with acute ischemic stroke (AIS). Limited studies have focused on the effect of END on functional outcome. Our aim was to determine the predictors of END after endovascular thrombectomy in AIS and its effect on functional outcome at 90 days.This is a secondary analysis of the DIRECT-MT trial. Patients who failed to complete endovascular thrombectomy were additionally excluded. END was defined as ≥4-point increase in National Institutes of Health Stroke Scale score between admission and 24 hours after endovascular thrombectomy. Multivariable logistic regression was used to identify predictors for END and its effect on the modified Rankin Scale (mRS) score at 90 days.Of 591 patients enrolled, 111 (18.8%) had postoperative END, which was associated with higher ordinal mRS score at 90 days (adjusted common OR (aOR) 6.968, 95% CI 4.444 to 10.926). Non-modifiable factors included baseline Alberta Stroke Program Early CT Score (aOR 0.883, 95% CI 0.790 to 0.987), systolic blood pressure (aOR 1.017, 95% CI 1.006 to 1.028), glucose level (aOR 1.178, 95% CI 1.090 to 1.273), collateral status (aOR 0.238, 95% CI 0.093 to 0.608), occlusion site (aOR 0.496, 95% CI 0.290 to 0.851) and the presence of an anterior communicating artery (aOR 0.323, 95% CI 0.148 to 0.707). Admission-to-groin puncture time (aOR 1.010, 95% CI 1.003 to 1.017), general anesthesia (aOR 2.299, 95% CI 1.193 to 4.444), number of passes (aOR 1.561, 95% CI 1.243 to 1.961) and contrast extravasation (aOR 6.096, 95% CI 1.543 to 24.088) were modifiable predictors for END.Postoperative END is associated with adverse functional outcome. Several non-modifiable and modifiable factors can predict END and support future treatment decision-making to improve the potential utility of endovascular thrombectomy.DIRECT-MT ClinicalTrials.gov NCT03469206.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
又见三皮发布了新的文献求助30
2秒前
Xdz发布了新的文献求助10
2秒前
无私诗云发布了新的文献求助10
3秒前
4秒前
ZhenpuWang完成签到,获得积分10
6秒前
6秒前
任性青烟完成签到,获得积分10
6秒前
6秒前
7秒前
背后归尘完成签到,获得积分10
9秒前
11秒前
12秒前
13秒前
14秒前
18秒前
清爽的真完成签到,获得积分10
19秒前
NZH发布了新的文献求助10
20秒前
自建完成签到,获得积分10
23秒前
贪玩的雁凡完成签到,获得积分10
24秒前
半糖完成签到,获得积分10
27秒前
28秒前
小高加油完成签到,获得积分10
30秒前
purple完成签到 ,获得积分10
30秒前
所所应助999z采纳,获得10
32秒前
32秒前
Mrmaxist发布了新的文献求助10
33秒前
不配.应助喜悦宛凝采纳,获得10
34秒前
李健的小迷弟应助ljs采纳,获得10
36秒前
NZH关闭了NZH文献求助
41秒前
43秒前
自信若灵完成签到 ,获得积分10
43秒前
顾矜应助科研通管家采纳,获得10
47秒前
科研通AI2S应助科研通管家采纳,获得10
47秒前
852应助科研通管家采纳,获得10
47秒前
研友_VZG7GZ应助sam采纳,获得10
47秒前
纯情的谷云完成签到 ,获得积分10
47秒前
啸海发布了新的文献求助10
47秒前
48秒前
bonnie发布了新的文献求助30
55秒前
55秒前
高分求助中
The ACS Guide to Scholarly Communication 2500
Sustainability in Tides Chemistry 2000
Studien zur Ideengeschichte der Gesetzgebung 1000
TM 5-855-1(Fundamentals of protective design for conventional weapons) 1000
Threaded Harmony: A Sustainable Approach to Fashion 810
Pharmacogenomics: Applications to Patient Care, Third Edition 800
A Dissection Guide & Atlas to the Rabbit 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3082501
求助须知:如何正确求助?哪些是违规求助? 2735655
关于积分的说明 7538441
捐赠科研通 2385263
什么是DOI,文献DOI怎么找? 1264761
科研通“疑难数据库(出版商)”最低求助积分说明 612786
版权声明 597665