Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial

被引:5
作者
Li, Guangwen [1 ]
Sun, Yujie [1 ]
Liu, Tonghui [1 ]
Yang, Pengfei [2 ]
Peng, Ya [3 ]
Chen, Wenhuo [4 ]
Zhang, Liyong [5 ]
Chu, Jianfeng [6 ]
Kuai, Dong [7 ]
Wang, Zibo [8 ]
Wu, Wei [9 ]
Xu, Yun [10 ]
Zhou, Bin [11 ]
Geng, Yu [12 ]
Yin, Congguo [13 ]
Li, Jiang [14 ]
Wang, Ming [15 ]
Peng, Xiaoxiang [16 ]
Xiao, Yaping [17 ]
Li, Minghua [18 ]
Zhang, Xianjun [1 ]
Liu, Peng [1 ]
Wang, Naidong [1 ]
Zhang, Yong [1 ]
机构
[1] Qingdao Univ, Affiliated Hosp, Dept Neurol, Qingdao, Peoples R China
[2] Naval Mil Med Univ, Changhai Hosp, Neurovasc Ctr, Shanghai, Peoples R China
[3] Changzhou First Peoples Hosp, Dept Neurosurg, Changzhou, Jiangsu, Peoples R China
[4] Fujian Med Univ, Dept Neurol, Zhangzhou Hosp, Zhangzhou, Peoples R China
[5] Liaocheng Peoples Hosp Brain Hosp, Dept Neurosurg, Liaocheng, Shandong, Peoples R China
[6] First Peoples Hosp Jining City, Dept Neurol, Jining, Peoples R China
[7] Shanxi Prov Cardiovasc Hosp, Dept Neurosurg, Taiyuan, Peoples R China
[8] Zhengzhou Univ, Affiliated Hosp 1, Dept Neurointervent, Zhengzhou, Henan, Peoples R China
[9] Shandong Univ, Qilu Hosp, Dept Neurol, Jinan, Shandong, Peoples R China
[10] Nanjing Gulou Hosp, Dept Neurol, Nanjing, Peoples R China
[11] Sun Yat Sen Univ, Affiliated Hosp 5, Cerebrovascular Dis Ctr, Dept Neurointervent, Zhuhai, Guangdong, Peoples R China
[12] Zhejiang Prov Peoples Hosp, Dept Neurol, Hangzhou, Zhejiang, Peoples R China
[13] Hangzhou First Peoples Hosp, Dept Neurol, Hangzhou, Zhejiang, Peoples R China
[14] Air Force Mil Med Univ, Affiliated Hosp 2, Dept Neurosurg, Xian, Peoples R China
[15] Nanyang Second Peoples Hosp, Dept Neurointervent, Nanyang, Peoples R China
[16] Third Peoples Hosp Hubei Prov, Dept Neurol, Wuhan, Peoples R China
[17] Shanghai Oriental Hosp, Dept Neurol, Shanghai, Peoples R China
[18] Shanghai Jiao Tong Univ, Affiliated Peoples Hosp 6, Inst Diagnost & Intervent Neuroradiol, Shanghai, Peoples R China
来源
BMJ OPEN | 2023年 / 13卷 / 12期
关键词
Stroke medicine; Stroke; STROKE MEDICINE; THROMBECTOMY; OCCLUSION;
D O I
10.1136/bmjopen-2023-078917
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectivesThis work aimed to analyse the risk factors for poor outcomes and mortality among patients with anterior large vessel occlusion (LVO) ischaemic stroke, despite successful recanalisation.Setting and participantsThis study conducted a secondary analysis among patients who underwent successful recanalisation in the CAPTURE trial. The trial took place between March 2018 and September 2020 at 21 sites in China. The CAPTURE trial enrolled patients who had an acute ischaemic stroke aged 18-80 years with LVO in anterior circulation.InterventionsThrombectomy was immediately performed using Neurohawk or the Solitaire FR after randomisation in CAPTURE trial. Rescue treatment was available for patients with severe residual stenosis caused by atherosclerosis.Primary and secondary outcome measuresThe primary goal was to predict poor 90-day survival or mortality within 90 days post-thrombectomy. Univariate analysis, using the chi 2 test or Fisher's exact test, was conducted for each selected factor. Subsequently, a multivariable analysis was performed on significant factors (p <= 0.10) identified through univariate analysis using the backward selection logistic regression approach.ResultsAmong the 207 recruited patients, 79 (38.2%) exhibited poor clinical outcomes, and 26 (12.6%) died within 90 days post-thrombectomy. Multivariate analysis revealed that the following factors were significantly associated with poor 90-day survival: age >= 67 years, internal carotid artery (ICA) occlusion (compared with middle cerebral artery (MCA) occlusion), initial National Institutes of Health Stroke Scale (NIHSS) score >= 17 and final modified Thrombolysis in Cerebral Infarction (mTICI) score 2b (compared with mTICI 3). Additionally, the following factors were significantly associated with mortality 90 days post-thrombectomy: initial NIHSS score >= 17, ICA occlusion (compared with MCA occlusion) and recanalisation with more than one pass.ConclusionsAge, NIHSS score, occlusion site, mTICI score and the number of passes can be independently used to predict poor 90-day survival or mortality within 90 days post-thrombectomy.Trial registration numberNCT04995757.
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页数:7
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