Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry

被引:3
作者
Tao, Chunrong [1 ]
Yuan, Guangxiong [2 ]
Xu, Pengfei [1 ]
Wang, Hao [3 ]
Zhou, Peiyang [4 ]
Yi, Tingyu [5 ]
Li, Kai [6 ]
Cui, Tao [7 ]
Gao, Jun [8 ]
Li, Rui [1 ]
Sun, Jun [1 ]
Zhang, Chao [1 ]
Wang, Li [1 ]
Liu, Tianlong [1 ]
Song, Jianlong [1 ]
Yin, Yamei [1 ]
Nguyen, Thanh N. [9 ,10 ]
Li, Qing [11 ,12 ]
Hu, Wei [1 ]
机构
[1] Univ Sci & Technol China, Affiliated Hosp USTC 1, Div Life Sci & Med, Dept Neurol, Hefei, Peoples R China
[2] Xiangtan Cent Hosp, Dept Emergency, Xiangtan, Peoples R China
[3] Linyi Peoples Hosp, Dept Neurol, Linyi, Shandong, Peoples R China
[4] Hubei Univ Med, Xiangyang Peoples Hosp 1, Dept Neurol, Xiangyang, Peoples R China
[5] Fujian Med Univ, Zhangzhou Affiliated Hosp, Dept Neurol, Zhangzhou, Peoples R China
[6] Heze Municipal Hosp, Dept Neurol, Heze, Shandong, Peoples R China
[7] Taihe Cty Peoples Hosp, Dept Neurol, Fuyang, Peoples R China
[8] Nanyang Cent Hosp, Dept Neurol, Nanyang, Peoples R China
[9] Boston Univ, Sch Med, Dept Radiol, Boston Med Ctr, Boston, MA 02118 USA
[10] Boston Univ, Sch Med, Boston Med Ctr, Dept Neurol, Boston, MA 02118 USA
[11] Univ Sci & Technol China, Affiliated Hosp USTC 1, Div Life Sci & Med, Dept Lab Med, Hefei, Peoples R China
[12] Univ Sci & Technol China, Affiliated Hosp USTC 1, Div Life Sci & Med, Core Facil Ctr, Hefei, Peoples R China
基金
中国国家自然科学基金; 中国博士后科学基金;
关键词
Stroke; Endovascular treatment; Basilar artery occlusion; Anesthetic management; ACUTE ISCHEMIC-STROKE; GENERAL-ANESTHESIA; CONSCIOUS SEDATION; THERAPY; THROMBECTOMY; CARE; REVASCULARIZATION; INTUBATION;
D O I
10.5853/jos.2023.00318
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. Methods This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. Results Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). Conclusion In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.
引用
收藏
页码:399 / +
页数:12
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